Toprol XL overdosage: Difference between revisions
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==Overdosage== | ==Overdosage== | ||
<u>'''Signs and Symptoms'''</u> | <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. | ||
<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. | <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. |
Revision as of 21:43, 9 February 2014
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Clinical data | |
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Trade names | Lopressor, Toprol-xl |
AHFS/Drugs.com | Monograph |
MedlinePlus | a682864 |
[[Regulation of therapeutic goods |Template:Engvar data]] |
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Pregnancy category | |
Routes of administration | Oral, IV |
ATC code | |
Legal status | |
Legal status |
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Pharmacokinetic data | |
Bioavailability | 12% |
Metabolism | Hepatic via CYP2D6, CYP3A4 |
Elimination half-life | 3-7 hours |
Excretion | Renal |
Identifiers | |
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CAS Number | |
PubChem CID | |
IUPHAR/BPS | |
DrugBank | |
ChemSpider | |
UNII | |
KEGG | |
ChEBI | |
ChEMBL | |
E number | {{#property:P628}} |
ECHA InfoCard | {{#property:P2566}}Lua error in Module:EditAtWikidata at line 36: attempt to index field 'wikibase' (a nil value). |
Chemical and physical data | |
Formula | C15H25NO3 |
Molar mass | 267.364 g/mol |
3D model (JSmol) | |
Melting point | 120 °C (248 °F) |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overdosage
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.
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.
There is very limited experience with the use of hemodialysis to remove metoprolol, however metoprolol is not highly protein bound.
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.
Hypotension: Treat underlying bradycardia. Consider intravenous vasopressor infusion, such as dopamine or norepinephrine.
Bronchospasm: Administer a beta2-agonist, including albuterol inhalation, or an oral theophylline derivative.
Cardiac Failure: Administer diuretics or digoxin for congestive heart failure. For cardiogenic shock, consider IV dobutamine, isoproterenol, or glucagon.[1]
References
Adapted from the FDA Package Insert.
- Pages with script errors
- Template:drugs.com link with non-standard subpage
- Drugs with non-standard legal status
- E number from Wikidata
- ECHA InfoCard ID from Wikidata
- Chemical articles with unknown parameter in Infobox drug
- Infobox drug articles with non-default infobox title
- Drugs
- Cardiovascular Drugs
- Beta blockers