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Few cases of propranolol overdose were reported. For a single intake, the maximum dose was 20 mg/kg. Symptomatic cases featured hypotension, hypoglycemic seizure, and restlessness/euphory/insomnia; for most cases, propranolol was maintained or reintroduced.
The toxicity of beta-blockers is an extension of their therapeutic effects:
- Cardiac symptoms of mild to moderate poisoning are decreased heart rate and hypotension. Atrioventricular blocks, intraventricular conduction delays, and congestive heart failure can occur with more severe poisoning.
- Bronchospasm may develop particularly in patients with asthma.
- Hypoglycemia may develop and manifestations of hypoglycemia (tremor, tachycardia) may be masked by other clinical effects of beta-blocker toxicity.
Support And Treatment
Place the patient on a cardiac monitor, and monitor vital signs, mental status and blood glucose. Give intravenous fluids for hypotension and atropine for bradycardia. Glucagon then catecholamines should be considered if the patient does not respond appropriately to IV fluid. Isoproterenol and aminophylline may be used for bronchospasm.
Propranolol is not dialyzable.
HEMANGEOL is contraindicated in the following conditions:
- Premature infants with corrected age < 5 weeks
- Infants weighing less than 2 kg
- Known hypersensitivity to propranolol or any of the excipients [see DESCRIPTION]
- Asthma or history of bronchospasm
- Heart rate < 80 beats per minute, greater than first degree heart block, or decompensated heart failure
- Blood pressure < 50/30 mmHg
Last reviewed on RxList: 4/3/2014
Additional Hemangeol Information
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