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| __NOTOC__
| | #REDIRECT [[Metoprolol succinate#Overdosage]] |
| {{Metoprolol}}
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| {{CMG}}
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| ==Overdosage==
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| <u>'''Signs and Symptoms'''</u> - Overdosage of TOPROL-XL may lead to severe bradycardia, hypotension, and cardiogenic shock. Clinical presentation can also include: atrioventricular block, heart failure, bronchospasm, hypoxia, impairment of consciousness/coma, nausea and vomiting.
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| <u>'''Treatment'''</u> – Consider treating the patient with intensive care. Patients with myocardial infarction or heart failure may be prone to significant hemodynamic instability. Seek consultation with a regional poison control center and a medical toxicologist as needed. Beta-blocker overdose may result in significant resistance to resuscitation with adrenergic agents, including beta-agonists. On the basis of the pharmacologic actions of metoprolol, employ the following measures.
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| There is very limited experience with the use of hemodialysis to remove metoprolol, however metoprolol is not highly protein bound.
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| <u>'''Bradycardia'''</u>: Administer intravenous atropine; repeat to effect. If the response is inadequate, consider intravenous isoproterenol or other positive chronotropic agents. Evaluate the need for transvenous pacemaker insertion.
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| <u>'''Hypotension'''</u>: Treat underlying bradycardia. Consider intravenous vasopressor infusion, such as dopamine or norepinephrine.
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| <u>'''Bronchospasm'''</u>: Administer a beta2-agonist, including albuterol inhalation, or an oral theophylline derivative.
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| <u>'''Cardiac Failure'''</u>: Administer diuretics or digoxin for congestive heart failure. For cardiogenic shock, consider IV dobutamine, isoproterenol, or glucagon.<ref name="dailymed.nlm.nih.gov">{{Cite web | last = | first = | title = TOPROL XL (METOPROLOL SUCCINATE) TABLET, EXTENDED RELEASE [BRYANT RANCH PREPACK] | url = http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=01038198-b4f0-41f3-9a9c-5c84e5a0d3b9 | publisher = | date = | accessdate = }}</ref>
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| ==References==
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| {{Reflist}}
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| {{FDA}}
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| [[Category:Drugs]]
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| [[Category:Cardiovascular Drugs]]
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| [[Category:Beta blockers]]
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