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Carvedilol Overdose with Quantitative Confirmation
Author(s) -
Bouchard Nicole C.,
Forde Jenice,
Hoffman Robert S.
Publication year - 2008
Publication title -
basic and clinical pharmacology and toxicology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.805
H-Index - 90
eISSN - 1742-7843
pISSN - 1742-7835
DOI - 10.1111/j.1742-7843.2008.00269.x
Subject(s) - carvedilol , heart rate , medicine , blood pressure , saline , anesthesia , antagonist , sinus rhythm , ingestion , pharmacology , heart failure , receptor , atrial fibrillation
Carvedilol is a non‐selective β‐adrenoreceptor antagonist that is also an antagonist at the α 1 ‐adrenoreceptor. This unique pharmacological effect may produce a different toxicodynamic profile compared to other β‐adrenoreceptor antagonists. Only one previous case of carvedilol overdose has been reported. Here, we report massive carvedilol ingestion confirmed by quantitative analysis. The case report deals with an 84‐year‐old man who chewed a total of 60 (6.25 mg) tablets and rapidly developed symptoms. Vital signs on presentation were systolic blood pressure 70 mmHg; heart rate 45 beats/min.; respirations 18 breaths/min.; temperature 37°. The electrocardiogram showed a junctional rhythm at 49 beats/min. The patient was treated with normal saline boluses, repeated glucagon boluses (2–3 mg each) and a dopamine infusion. At 14 hr after ingestion, he was weaned off vasopressors and was in a normal sinus rhythm. Quantitative confirmation showed a carvedilol serum concentration of 472 ng/ml (steady‐state concentration 8.5 ng/ml during 6.25 mg twice daily dosing). Despite its unique pharmacological properties, the clinical manifestations of carvedilol overdose appear similar to other β‐adrenoreceptor antagonists.