Beta Blockers

Question 1

B blockers: Risk assessment

Answer 1

toxicity doesn't correlate well with ingested dose
increase risk if:
- propranolol/ sotalol
- CCB / Digoxin co ingestion
-underlying heart or lung dz
-old
Propranolol: 1g toxic

Question 2

B blockers clinical life threats

Answer 2

CVS: hypo/ brady/ heart blocks/
ECG: QRS wide- propranolol/ QT long Sotalol
CNS: delirium/ coma/ sz (propranolol)
Other: bronchospasm/ Pulm edema/ HyperK/ Hypoglycaemia

Question 3

B Blockers: Resus

Answer 3

Brady & Hypotension:
-atropine 100-300mcg IV temporising
-isoprenaline infusion: 4mcg/min IV
-adrenaline
- HIET: 
Bolus: 50ml of 50% dextrose/ act rapid 1U/Kg IV/ 
Infusion: 25g/hr + actrapid 0.5u/kg/hr- aim euglycaemia
Wide QRS: propranolol
- Bicarb 1-2mmol/kg q 2 min
Torsades : Sotalol
- isoprenaline
- magnesium
- over drive pacing

Question 4

B Blocker: Decontamination

Answer 4

< 2 hrs: AC

CARE with propranolol- sz

Question 5

B Blocker: EE/ Antidotes

Answer 5

None