Jn. Love et al., Acute beta blocker overdose: Factors associated with the development of cardiovascular morbidity, J TOX-CLIN, 38(3), 2000, pp. 275-281
Objective: To identify factors in exposures to beta blockers (beta-adrenerg
ic receptor antagonists) that are associated with the development of cardio
vascular morbidity and contribute to disposition decisions from the emergen
cy department. Methods: Prospective cohort of 280 beta blocker exposures re
ported to 2 regional poison centers. Multiple logistic regression was used
to determine association of various clinical factors and outcome, Results:
In this series of beta blocker exposures, 41 (15%) developed cardiovascular
morbidity and 4 (1.4%) died. A history of cardioactive coingestant was the
only factor significantly associated with the development of cardiovascula
r morbidity (p <.05). When cases reporting cardioactive coingestants were e
xcluded, a history of ingesting a beta blocker with membrane stabilizing ac
tivity was significantly associated with the development of cardiovascular
morbidity (p <.05), All those In whom the timing of symptoms could be deter
mined, developed symptoms within 6 hours of ingestion. Conclusions: The sin
gle most important factor associated with the development of cardiovascular
morbidity in beta blocker ingestion is a history of a cardioactive coinges
tant, primarily calcium channel blockers, cyclic antidepressants, and neuro
leptics, In the absence of such coingestion, exposure to a beta blocker wit
h membrane stabilizing activity is associated with an increased risk of car
diovascular morbidity. Beta blocker ingestion is unlikely to result in symp
toms if the patient remains asymptomatic for 6 hours after the time of inge
stion.