Doxazosin/propranolol overdose

Reactions 1479, p13 - 23 Nov 2013 O S Doxazosin/propranolol overdose Cardiovascular collapse: case report A 34-year-old man experienced cardiovascular collapse following a mixed ingestion of doxazosin and propranolol. The man, who had a history of hypertension, reportedly ingested over 100 tablets of doxazosin 4mg and propranolol 10mg [doses and indication not clearly stated]. He was found lethargic [time to reaction onset not stated], and he was intubated. Treatment was initiated, and he was transferred out of prison to another institution. He was hypotensive and bradycardic. The man started receiving soya oil emulsion [Intralipid] and insulin. Due to oliguric renal failure, continuous venovenous haemofiltration (CVVH) was initiated. He started receiving isoproterenol and vasopressin due to the persistent hypotension, and he underwent placement of a temporary pacemaker. Haemodynamic monitoring revealed vasodilatory shock. He started receiving phenylephrine. His haemodynamics improved by hospital day 2, and he was extubated. When he was discharged, he was neurologically intact. Author comment: "In this case of cardiovascular collapse following a mixed ingestion of doxazosin and propranolol, advanced hemodynamic monitoring suggested a severe vasodilatory shock and his doxazosin level indicates a large exposure." Kao L, et al. Advanced hemodynamic monitoring in doxazosin and propranolol induced cardiovascular collapse Clinical Toxicology 51: 674 abstr. 218, No. 7, Aug 2013. Available from: URL: http://informahealthcare.com/doi/ abs/10.3109/15563650.2013.817658 [abstract] - USA 803095904 1 Reactions 23 Nov 2013 No. 1479 0114-9954/13/1479-0001/$14.95 Adis © 2013 Springer International Publishing AG. All rights reserved

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Transcript of Doxazosin/propranolol overdose

Reactions 1479, p13 - 23 Nov 2013

O SDoxazosin/propranolol overdose

Cardiovascular collapse: case reportA 34-year-old man experienced cardiovascular collapse

following a mixed ingestion of doxazosin and propranolol.The man, who had a history of hypertension, reportedly

ingested over 100 tablets of doxazosin 4mg and propranolol10mg [doses and indication not clearly stated]. He was foundlethargic [time to reaction onset not stated], and he wasintubated. Treatment was initiated, and he was transferred outof prison to another institution. He was hypotensive andbradycardic.

The man started receiving soya oil emulsion [Intralipid] andinsulin. Due to oliguric renal failure, continuous venovenoushaemofiltration (CVVH) was initiated. He started receivingisoproterenol and vasopressin due to the persistenthypotension, and he underwent placement of a temporarypacemaker. Haemodynamic monitoring revealed vasodilatoryshock. He started receiving phenylephrine. Hishaemodynamics improved by hospital day 2, and he wasextubated. When he was discharged, he was neurologicallyintact.

Author comment: "In this case of cardiovascular collapsefollowing a mixed ingestion of doxazosin and propranolol,advanced hemodynamic monitoring suggested a severevasodilatory shock and his doxazosin level indicates a largeexposure."Kao L, et al. Advanced hemodynamic monitoring in doxazosin and propranololinduced cardiovascular collapse Clinical Toxicology 51: 674 abstr. 218, No. 7,Aug 2013. Available from: URL: http://informahealthcare.com/doi/abs/10.3109/15563650.2013.817658 [abstract] - USA 803095904