β-Adrenergic Blocker Poisoning Management Quiz
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Questions and Answers

Which β-adrenergic blocker is mentioned as having intrinsic sympathomimetic activity (ISA)?

  • Pindolol
  • Sotalol
  • Propranolol
  • Acebutolol (correct)

    • What is the cardiac effect of high doses of β-adrenergic blockers with intrinsic sympathomimetic activity (ISA)?

  • Ventricular dysrhythmias
  • Bradycardia and hypotension
  • Tachycardia and hypertension (correct)
  • Atrioventricular (AV) block

    • What contributes to the cardiac depressant effects of propranolol?

  • Membrane depressant effect (correct)
  • Prolonged QT interval
  • CNS effects
  • Decreased renal blood flow

    • Which β-adrenergic blocker is mentioned as causing prolongation of the QT interval?

    <p>Sotalol</p> Signup and view all the answers

    What is the most commonly reported sign of β-adrenergic blocker poisoning?

    <p>Bradycardia</p> Signup and view all the answers

    What can worsen the prognosis in case of β-adrenergic blocker poisoning?

    <p>Chronic obstructive pulmonary disease (COPD)</p> Signup and view all the answers

    What is a potential complication of therapeutic use of sotalol?

    <p>Torsades de pointes</p> Signup and view all the answers

    Why is blood drug level determination alone unreliable for assessing possible overdose of β-adrenergic blockers?

    <p>Clinical symptoms persist beyond the drug’s half life</p> Signup and view all the answers

    What electrographic changes are associated with β-adrenergic blocker poisoning?

    <p>Prolonged PR interval, absence of P waves</p> Signup and view all the answers

    What effect does an overdose of β-adrenergic blockers have on myocardial contractility?

    <p>Diminished contractility</p> Signup and view all the answers

    What is the primary reason for the toxicity of β-adrenergic antagonists?

    <p>Their ability to competitively antagonize the action of catecholamines at cardiac β-adrenergic receptors</p> Signup and view all the answers

    What is the main purpose of using β-adrenergic blockers in medical treatment?

    <p>Treatment of hypertension, arrhythmia, angina, glaucoma, and migraine prophylaxis</p> Signup and view all the answers

    How do the pharmacologic and pharmacokinetic differences among β-adrenergic blockers affect their use?

    <p>Influence their therapeutic applications, incidence of side effects, and type and severity of toxic reactions</p> Signup and view all the answers

    What is the most common use of β-adrenergic blockers?

    <p>Treatment of hypertension</p> Signup and view all the answers

    What is the main mechanism of action of β-adrenergic antagonists leading to toxicity?

    <p>Competitively antagonizing the action of catecholamines at cardiac β-adrenergic receptors</p> Signup and view all the answers

    What is the impact of the pharmacologic and pharmacokinetic differences among β-adrenergic blockers on their side effects?

    <p>Influence the incidence of side effects</p> Signup and view all the answers

    What role do β-adrenergic blockers play in the treatment of angina?

    <p>They are used for the treatment of angina</p> Signup and view all the answers

    What is the most significant influence of the pharmacologic and pharmacokinetic differences among β-adrenergic blockers?

    <p>Their influence on therapeutic applications</p> Signup and view all the answers

    What is the primary effect of β-adrenergic blockers on the incidence of side effects?

    <p>They influence the incidence of side effects</p> Signup and view all the answers

    What is the primary reason for using β-adrenergic blockers in the treatment of arrhythmia?

    <p>Their ability to regulate heart rhythm</p> Signup and view all the answers

    Which symptom is characteristic of propranolol poisoning?

    <p>Seizures</p> Signup and view all the answers

    What is the recommended treatment for bradycardia in β-adrenergic blocker poisoning?

    <p>Atropine</p> Signup and view all the answers

    What is the potential risk of orogastric lavage in β-adrenergic blocker poisoning?

    <p>Vagal stimulation</p> Signup and view all the answers

    Which medication is preferred to be introduced first in β-adrenergic blocker overdose?

    <p>Glucagon</p> Signup and view all the answers

    What is the potential effect of activated charcoal in β-adrenergic blocker poisoning?

    <p>Worsening bradycardia</p> Signup and view all the answers

    What is the characteristic cardiac change in β-adrenergic blocker poisoning?

    <p>Prolonged QRS interval</p> Signup and view all the answers

    Which medication may be considered in β-adrenergic antagonist overdose if other treatments fail?

    <p>Phosphodiesterase inhibitors</p> Signup and view all the answers

    What is the potential effect of orogastric lavage in β-adrenergic blocker poisoning?

    <p>Vagal stimulation</p> Signup and view all the answers

    What is the potential risk of giving glucose in β-adrenergic blocker poisoning?

    <p>Hyperglycemia</p> Signup and view all the answers

    What is the potential risk of whole bowel irrigation with polyethylene glycol in β-adrenergic blocker poisoning?

    <p>Worsening bradycardia</p> Signup and view all the answers

    What is the primary reason for the toxicity of β-adrenergic antagonists?

    <p>Competitive antagonism of catecholamines at cardiac β-adrenergic receptors</p> Signup and view all the answers

    What is the most common use of β-adrenergic blockers?

    <p>Hypertension</p> Signup and view all the answers

    What contributes to the cardiac depressant effects of propranolol?

    <p>Competitive antagonism of acetylcholine at cardiac muscarinic receptors</p> Signup and view all the answers

    What electrographic changes are associated with β-adrenergic blocker poisoning?

    <p>Prolongation of the QT interval</p> Signup and view all the answers

    What is the primary effect of β-adrenergic blockers on the incidence of side effects?

    <p>Reduction</p> Signup and view all the answers

    What is the potential risk of giving glucose in β-adrenergic blocker poisoning?

    <p>Exacerbation of hypoglycemia</p> Signup and view all the answers

    What is the potential effect of orogastric lavage in β-adrenergic blocker poisoning?

    <p>Reduction of drug absorption</p> Signup and view all the answers

    What is the potential risk of whole bowel irrigation with polyethylene glycol in β-adrenergic blocker poisoning?

    <p>Exacerbation of drug absorption</p> Signup and view all the answers

    What is the recommended treatment for bradycardia in β-adrenergic blocker poisoning?

    <p>Atropine</p> Signup and view all the answers

    What is the potential effect of activated charcoal in β-adrenergic blocker poisoning?

    <p>Reduction of drug absorption</p> Signup and view all the answers

    What electrographic changes are associated with β-adrenergic blocker poisoning?

    <p>Prolonged PR interval, widened QRS complex, absence of P waves, prolonged QT interval</p> Signup and view all the answers

    What contributes to the cardiac depressant effects of propranolol?

    <p>Membrane depressant effect</p> Signup and view all the answers

    What is the potential complication of therapeutic use of sotalol?

    <p>Torsades de pointes &amp; ventricular dysrhythmias</p> Signup and view all the answers

    What is the impact of the pharmacologic and pharmacokinetic differences among β-adrenergic blockers on their side effects?

    <p>It influences the incidence and severity of side effects</p> Signup and view all the answers

    What is the most significant influence of the pharmacologic and pharmacokinetic differences among β-adrenergic blockers?

    <p>Their CNS effects</p> Signup and view all the answers

    What is the primary reason for using β-adrenergic blockers in the treatment of arrhythmia?

    <p>To reduce heart rate and contractility</p> Signup and view all the answers

    What is the potential risk of giving glucose in β-adrenergic blocker poisoning?

    <p>It may worsen hypoglycemia</p> Signup and view all the answers

    What is the potential risk of whole bowel irrigation with polyethylene glycol in β-adrenergic blocker poisoning?

    <p>It may cause fluid overload</p> Signup and view all the answers

    What is the potential risk of orogastric lavage in β-adrenergic blocker poisoning?

    <p>It may cause aspiration pneumonia</p> Signup and view all the answers

    What is the most commonly reported sign of β-adrenergic blocker poisoning?

    <p>Bradycardia</p> Signup and view all the answers

    Which of the following is a characteristic of propranolol poisoning?

    <p>Bradycardia and impaired AV conduction</p> Signup and view all the answers

    What is the recommended management for sustained release β-adrenergic blocker poisoning?

    <p>Whole bowel irrigation with polyethylene glycol</p> Signup and view all the answers

    What is the primary effect of glucagon in the treatment of β-adrenergic antagonist overdose?

    <p>Positive inotropic and chronotropic activity</p> Signup and view all the answers

    In the management of bradycardia in β-adrenergic blocker poisoning, what is the next step if the patient fails to respond to atropine and fluids?

    <p>Use of inotropes</p> Signup and view all the answers

    What is the potential complication of orogastric lavage in β-adrenergic blocker poisoning?

    <p>Vagal stimulation leading to bradycardia</p> Signup and view all the answers

    Which medication may be considered if glucagon and inotropes fail in the management of β-adrenergic antagonist overdose?

    <p>Phosphodiesterase inhibitors</p> Signup and view all the answers

    What is the cardiac effect of high doses of β-adrenergic blockers with intrinsic sympathomimetic activity (ISA)?

    <p>Prolonged QT interval</p> Signup and view all the answers

    What is the potential risk of activated charcoal administration in β-adrenergic blocker poisoning?

    <p>Worsening of hypotension</p> Signup and view all the answers

    What is the primary reason for giving glucose in the management of β-adrenergic blocker poisoning?

    <p>To counteract hypoglycemia</p> Signup and view all the answers

    What is the potential effect of orogastric lavage in β-adrenergic blocker poisoning?

    <p>Worsening of bradycardia</p> Signup and view all the answers

    Study Notes

    Management of β-Adrenergic Blocker Poisoning

    • Cardiac changes in β-adrenergic blocker poisonings are not uniformly reported and occur most frequently with drugs that have membrane stabilizing action.
    • Propranolol possesses the most membrane stabilizing activity in its class and its poisoning is characterized by coma, seizures, hypotension, bradycardia, impaired AV conduction, and prolonged QRS interval.
    • Ventricular tachydysrhythmias may also occur in β-adrenergic blocker poisoning.
    • Management of poisoning includes maintaining airway ventilation, giving atropine before laryngoscopy, orogastric lavage, and activated charcoal administration.
    • Orogastric lavage causes vagal stimulation and carries the risk of worsening bradycardia, so it is reasonable to pretreat patients with atropine.
    • Activated charcoal can be given repeatedly during the first 24 hours and whole bowel irrigation with polyethylene glycol should be considered for sustained release preparations.
    • Other areas of management include giving glucose for hypoglycemia, diazepam for convulsions, and monitoring potassium levels.
    • In the treatment of bradycardia, atropine may be given if the patient is compromised hemodynamically and the hypotensive patient may respond to fluids in the absence of pulmonary edema.
    • Patients who fail to respond to atropine and fluids require management with inotropes.
    • When time permits, it is preferable to introduce medications sequentially, starting with glucagon followed by calcium, high dose insulin euglycemia therapy, a catecholamine, and if this fails, phosphodiesterase inhibitors.
    • Glucagon produces positive inotropic and chronotropic activity and improves AV conduction.
    • The phosphodiesterase inhibitors inamrinone and milrinone are theoretically beneficial in β-adrenergic antagonist overdose, and hemoperfusion and hemodialysis may be considered in cases involving nadolol and atenolol.

    Management of β-Adrenergic Blocker Poisoning

    • Cardiac changes in β-adrenergic blocker poisonings are not uniformly reported and occur most frequently with drugs that have membrane stabilizing action.
    • Propranolol possesses the most membrane stabilizing activity in its class and its poisoning is characterized by coma, seizures, hypotension, bradycardia, impaired AV conduction, and prolonged QRS interval.
    • Ventricular tachydysrhythmias may also occur in β-adrenergic blocker poisoning.
    • Management of poisoning includes maintaining airway ventilation, giving atropine before laryngoscopy, orogastric lavage, and activated charcoal administration.
    • Orogastric lavage causes vagal stimulation and carries the risk of worsening bradycardia, so it is reasonable to pretreat patients with atropine.
    • Activated charcoal can be given repeatedly during the first 24 hours and whole bowel irrigation with polyethylene glycol should be considered for sustained release preparations.
    • Other areas of management include giving glucose for hypoglycemia, diazepam for convulsions, and monitoring potassium levels.
    • In the treatment of bradycardia, atropine may be given if the patient is compromised hemodynamically and the hypotensive patient may respond to fluids in the absence of pulmonary edema.
    • Patients who fail to respond to atropine and fluids require management with inotropes.
    • When time permits, it is preferable to introduce medications sequentially, starting with glucagon followed by calcium, high dose insulin euglycemia therapy, a catecholamine, and if this fails, phosphodiesterase inhibitors.
    • Glucagon produces positive inotropic and chronotropic activity and improves AV conduction.
    • The phosphodiesterase inhibitors inamrinone and milrinone are theoretically beneficial in β-adrenergic antagonist overdose, and hemoperfusion and hemodialysis may be considered in cases involving nadolol and atenolol.

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    Toxicity of β-Adrenergic Blockers PDF

    Description

    Test your knowledge of the management of β-adrenergic blocker poisoning with this quiz. Explore the cardiac changes, treatment options, and key considerations for managing this type of poisoning.

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