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Most overdoses of propranolol are mild and respond to supportive care.
Propranolol is not significantly dialyzable.
Hypotension and bradycardia have been reported following propranolol overdose and should be treated appropriately. Glucagon can exert potent inotropic and chronotropic effects and may be particularly useful for the treatment of hypotension or depressed myocardial function after a propranolol overdose.
Glucagon should be administered as 50-150 mcg/kg intravenously followed by continuous drip of 1-5 mg/hour for positive chronotropic effect. Isoproterenol, dopamine or phosphodiesterase inhibitors may also be useful. Epinephrine, however, may provoke uncontrolled hypertension. Bradycardia can be treated with atropine or isoproterenol. Serious bradycardia may require temporary cardiac pacing.
Monitor the electrocardiogram, pulse, blood pressure, neurobehavioral status and intake and output balance. Isoproterenol and aminophylline may be used for bronchospasm.
INNOPRAN XL is contraindicated in patients with:
- Cardiogenic shock or decompensated heart failure
- Sinus bradycardia, sick sinus syndrome, and greater than first-degree block unless a permanent pacemaker is in place
- Bronchial asthma
- Known hypersensitivity (e.g., anaphylactic reaction) to propranolol hydrochloride or any of the components of INNOPRAN XL.
Last reviewed on RxList: 12/23/2013
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