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Beta-Blocker Poisoning Updated 12/2010

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BASICS

  • Description

DIAGNOSIS

  • Signs and Symptoms
  • Essential Workup
  • Tests
  • Differential Diagnosis

TREATMENT

  • Pre-hospital
  • Initial Stabilization
  • ED Treatment
  • Medication (Drugs)
  • In-patient Considerations

Ongoing Care

  • Follow-Up Recommendations
The following is an excerpt....
BASICS
Description
Normal Physiology
  • Cardiovascular: β1-receptors:
    • ATP converted to cAMP by adenyl cyclase with stimulation of β-receptors
    • cAMP activates protein kinase, which phosphorylates proteins of the sarcoplasmic reticulum.
    • Sarcoplasmic reticulum releases calcium.
    • Excitation-contraction coupling occurs.
  • Effects of β-blockers:
    • Cardiovascular:
      • Decreased excitation/contraction
      • Membrane stabilizing activity
      • Sodium channel blockade causes a prolongation of the QRS complex (with some agents).
      • Prolongation of QTc interval leading to ventricular dysrhythmias (with some agents)
      • Intrinsic sympathomimetic activity
      • Partial agonist properties (with some agents)
    • Neurologic:

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