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| __NOTOC__
| | #REDIRECT [[Metoprolol succinate#Overdosage]] |
| {{Metoprolol}}
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| {{CMG}}
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| '''Signs and Symptoms''' – 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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| '''Treatment''' – 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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| '''Bradycardia''': 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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| '''Hypotension''': Treat underlying [[bradycardia]]. Consider intravenous vasopressor infusion, such as [[dopamine]] or [[norepinephrine]].
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| '''Bronchospasm''': Administer a [[beta2]]-agonist, including [[albuterol]] inhalation, or an oral [[theophylline]] derivative.
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| '''Cardiac Failure''': Administer [[diuretic]]s 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:Antianginals]]
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| [[Category:Antiarrhythmic agents]]
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| [[Category:Antihypertensive agents]]
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| [[Category:Antimigraine drugs]]
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| [[Category:Beta blockers]]
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| [[Category:Cardiovascular Drugs]]
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