Atenolol overdose
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overdosage topics
Overdosage with Atenolol has been reported with patients surviving acute doses as high as 5 g. One death was reported in a man who may have taken as much as 10 g acutely.
The predominant symptoms reported following Atenolol overdose are lethargy, disorder of respiratory drive, wheezing, sinus pause and bradycardia. Additionally, common effects associated with overdosage of any beta-adrenergic blocking agent and which might also be expected in Atenolol overdose are congestive heart failure, hypotension, bronchospasm and/or hypoglycemia.
Treatment of overdose should be directed to the removal of any unabsorbed drug by induced emesis, gastric lavage, or administration of activated charcoal. Atenolol can be removed from the general circulation by hemodialysis. Other treatment modalities should be employed at the physician's discretion and may include:
Bradycardia
Heart Block (Second or Third Degree)
Cardiac Failure
Hypotension
Bronchospasm
Hypoglycemia
Bradycardia
Atropine intravenously. If there is no response to vagal blockade, give isoproterenol cautiously. In refractory cases, a transvenous cardiac pacemaker may be indicated.
Heart Block (Second or Third Degree)
Isoproterenol or transvenous cardiac pacemaker.
Cardiac Failure
Digitalize the patient and administer a diuretic. Glucagon has been reported to be useful.
Hypotension
Vasopressors such as dopamine or norepinephrine (levarterenol). Monitor blood pressure continuously.
Bronchospasm
A beta-2 stimulant such as isoproterenol or terbutaline and/or aminophylline.
Hypoglycemia
Intravenous glucose.
Based on the severity of symptoms, management may require intensive support care and facilities for applying cardiac and respiratory support.
Adapted from the FDA Package Insert.