ABSTRACT
A case of massive atenolol ingestion leading to hypotension in association with PR and QRS interval prolongation on the electrocardiogram is presented. These clinical findings are identical to those attributed to the membrane-stabilizing activity of propranolol and other lipophilic beta-blockers. It is commonly believed that hydrophilic agents such as atenolol lack this activity. A review of the literature reveals that hydrophilic beta-blockers may have membrane-stabilizing activity, though much higher concentrations are required to produce this action in comparison with lipophilic agents. This case and a review of the literature provides a potential pathophysiological basis for atenolol-induced haemodynamic depression.
Subject(s)
Adrenergic beta-Antagonists/poisoning , Antihypertensive Agents/poisoning , Atenolol/poisoning , Hypotension/chemically induced , Drug Overdose , Electrocardiography , Heart/drug effects , Humans , Male , Middle AgedABSTRACT
A retrospective study of 2,526 calls made to a regional poison center demonstrated the value of telephone follow-up of poison exposures. Further treatment recommendations were required in 21.2% of follow-up calls, more than 25% of which were made to physicians. Poison prevention education and data collection were accomplished in more than 95% of cases. Twenty-four telephone follow-up calls corrected major treatment errors, corresponding to a dramatic change in patient management more than twice each week. This study delineates the functions and value of the follow-up call in the treatment and prevention of poisonings and in toxicologic research. Because the effective use of this procedure is limited to comprehensive poison centers with vast resources and full-time staff, this study further supports regionalization to promote maximal utilization of this and other elements of poison control.
