Dergiler / Journal of Experimental and Clinical Medicine / 2022 / Volume: 39 Issue: 4

Clinical Toxicology of Propranolol and Metoprolol Overdose in Adults

Figen Özcan(Recep Tayyip Erdoğan University Training and Research Hospital)0000-0002-8593-1079
Mehmet Altuntaş(RECEP TAYYIP ERDOGAN UNIVERSITY)0000-0001-5624-968X
Celal Katı(ONDOKUZ MAYIS UNIVERSITY)0000-0002-1201-7059
Sayfa
—
Yayın Tarihi
2022-10-29
DOI
—
🏛️Bu makalenin bibliyografik verileri ve tam metin bağlantısı DergiPark üzerinden sağlanmıştır.
DergiPark Kaydı ↗
✨

Yapay Zeka Hızlı Bakış & Çıkarımlar

AI Insight
⚡ TL;DR(1 Cümlede Hızlı Çıkarım)

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.

📌 3 Maddede Bu Makale

🎯
Amaç & Hipotez:Beta-adrenergic receptor antagonists potentially risk causing fatal poisoning when taken over the daily recommended doses.
📊
Temel Bulgular & Veri:This 7-year-long retrospective cohort study was conducted among on 43 adult patients who received overdose propranolol (n= 22) and metoprolol (n= 21).
💡
Sonuç & Katkı: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.
🔬Tür:Research Article
📍Kapsam:2000 Verileri
⚙️Değişkenler:Beta Blocker Poisoning · Propranolol · Metoprolol

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.

🔖

Bu Makaleye Atıf Yap

Özcan, F., Altuntaş, M., Katı, C. (2022). Clinical Toxicology of Propranolol and Metoprolol Overdose in Adults. Journal of Experimental and Clinical Medicine, Volume: 39 Issue: 4. https://ajindex.com/articles/1422957

📄 Tam Metin PDF Okuyucu

📄

PDF görüntüleyici hazırlanıyor...

Kaynakça (13)

  1. Reith DM, Dawson AH, Whyte IM, Buckley NA, Sayer GP. Relative Toxicity of Beta Blockers in Overdose. Journal of Toxicology: Clinical Toxicology. 1996; 34(3):273–8.
  2. Metra M, Cas LD, Cleland JGF. Pharmacokinetic and Pharmacodynamic Characteristics of β-Blockers: When Differences May Matter. Journal of Cardiac Failure. 2006; 12(3):177–81.
  3. Love JN, Howell JM, Litovitz TL, Klein-Schwartz W. Acute beta blocker overdose: factors associated with the development of cardiovascular morbidity. J Toxicol Clin Toxicol. 2000; 38(3):275–81.
  4. Jaillon P. Relevance of intrinsic sympathomimetic activity for beta blockers. Am J Cardiol. 1990; 66(9):21C-23C.
  5. Bylund DB, Gruetter CA. Propranolol. xPharm: The Comprehensive Pharmacology Reference. 2007, p. 1–9.
  6. Gruetter CA. Metoprolol. In: xPharm: The Comprehensive Pharmacology Reference. 2007, p. 1–7.
  7. Ulusal Zehir Danışma Merkezi (UZEM) Ayrıntılı Faaliyet Raporları 2014-2020 Yılları. TC Sağlık Bakanlığı Halk Sağlığı Genel Müdürlüğü [Internet]. 2021; Available from: https://hsgm.saglik.gov.tr/depo/kurumsal/yayinlarimiz/Raporlar/Uzem/uzem_raporlari_2014-2020.pdf
  8. Gummin DD, Mowry JB, Beuhler MC, Spyker DA, Bronstein AC, Rivers LJ, et al. 2020 Annual Report of the American Association of Poison Control Centers’ National Poison Data System (NPDS): 38th Annual Report. Clin Toxicol (Phila). 2021; 59(12):1282–501.
  9. Lauterbach M. Clinical toxicology of beta-blocker overdose in adults. Basic Clin Pharmacol Toxicol. 2019; 125(2):178–86.
  10. Kriikku P, Pelkonen S, Kaukonen M, Ojanperä I. Propranolol and metoprolol: Two comparable drugs with very different post-mortem toxicological profiles. Forensic Science International. 2021; 327:110978.
  11. Khalid MM, Galuska MA, Hamilton RJ. Beta-Blocker Toxicity. In Treasure Island (FL); StatPearls Publishing; July 26, 2021.
  12. Love JN, Enlow B, Howell JM, Klein-Schwartz W, Litovitz TL. Electrocardiographic changes associated with β-blocker toxicity. Annals of Emergency Medicine. 2002; 40(6):603–10.
  13. Rotella JA, Greene SL, Koutsogiannis Z, Graudins A, Hung Leang Y, Kuan K, et al. Treatment for beta-blocker poisoning: a systematic review. Clinical Toxicology. 2020;58(10):943–83.