1. Clinical toxicology of propranolol and metoprolol overdose in adults
- Author
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ÖZCAN, Figen, ALTUNTAŞ, Mehmet, KATI, Celal, RTEÜ, Tıp Fakültesi, Cerrahi Tıp Bilimleri Bölümü, Özcan, Figen, and Altuntaş, Mehmet
- Subjects
Health Care Sciences and Services ,Beta Blocker Poisoning ,Propranolol ,Metoprolol ,Emergency Medicine ,Emergency medicine ,propranolol ,General Medicine ,Sağlık Bilimleri ve Hizmetleri ,Beta blocker poisoning ,General Biochemistry, Genetics and Molecular Biology - Abstract
Beta-adrenergic receptor antagonists potentially risk causing fatal poisoning when taken over the daily recommended doses. The aim of this study is to investigate the differences and potential dose-related effects of propranolol and metoprolol toxicity depending on their selectivity. This 7-year-long retrospective cohort study was conducted among on 43 adult patients who received overdose propranolol (n= 22) and metoprolol (n= 21). Patients were divided into groups, with a daily overdose ≥ 240 mg/day for propranolol, ≥ 200 mg/day for metoprolol, and toxic dose ≥ 400 mg/day for both drugs. The groups were compared in terms of admission symptoms, heart rate, blood pressure, electrocardiography findings, cardiovascular effects, toxicity severity scores, treatment, follow-up times, and outcomes. Thirty-four (79.1%) of the patients who exceeded the daily dose were female, and there were no statistically significant differences between the groups in terms of gender (p= 0,281). The mean age was 29 (18-72) years, and there were no statistically significant differences between groups in terms of mean age (p= 0,192). When the vitals of the patients who exceeded the daily dose was examined, it was found that 23 (54.8%) patients had bradycardia, and 20 (46.5%) patients had hypotension. 65.2% of the bradycardia patients and 70% of the hypotensive patients were in the propranolol overdose group (p= 0,030 p= 0,021, respectively). Mean dose of symptomatic propranolol overdose patients (n= 12) was found as 1256 (280-2000) mg, mean dose of symptomatic metoprolol overdose patients (n= 11) was found as 559 (250-1000) mg. When toxic dose (≥ 400 mg) intakes were compared, more cardiovascular effects were observed in the propranolol group (p= 0,014). As a result, it was determined that Propranolol overdose has more cardiovascular effects than metoprolol overdose and there is a linear dose-symptom relationship for Propranolol.
- Published
- 2022