In beta-blocker overdose, which of the following best describes the typical clinical picture and a standard component of its management?

In beta-blocker overdose, which of the following best describes the typical clinical picture and a standard component of its management?

• A. Severe bradycardia and hypotension with possible bronchospasm; treat with IV fluids, atropine, and supportive care; avoid nonselective beta-blockers in asthma.
• B. Hypertension and tachycardia; administer additional beta-blocker.
• C. Hyperglycemia; administer insulin infusion.
• D. Seizures; administer benzodiazepines.

Answer: (A)

Beta-blocker overdose best presents with the heart and circulation being depressed. The heart rate drops (severe bradycardia) and blood pressure falls (hypotension) because the beta receptors controlling heart rhythm and contractility are blocked. If the overdose involves a nonselective beta-blocker, there can also be airway constriction (bronchospasm) due to beta-2 blockade, which is particularly concerning for people with asthma. The standard approach to management centers on supporting perfusion and heart rate: giving IV fluids to improve preload and blood flow, using atropine to counteract the bradycardia, and providing general supportive care (oxygen, monitoring, and vasopressors if needed). It’s also important to avoid nonselective beta-blockers in patients with asthma because of the risk of bronchospasm. In more severe cases, additional treatments like glucagon can be considered, but initial and typical management focuses on fluids, atropine, and supportive care, with caution about asthma history.

Beta-blocker overdose best presents with the heart and circulation being depressed. The heart rate drops (severe bradycardia) and blood pressure falls (hypotension) because the beta receptors controlling heart rhythm and contractility are blocked. If the overdose involves a nonselective beta-blocker, there can also be airway constriction (bronchospasm) due to beta-2 blockade, which is particularly concerning for people with asthma. The standard approach to management centers on supporting perfusion and heart rate: giving IV fluids to improve preload and blood flow, using atropine to counteract the bradycardia, and providing general supportive care (oxygen, monitoring, and vasopressors if needed). It’s also important to avoid nonselective beta-blockers in patients with asthma because of the risk of bronchospasm. In more severe cases, additional treatments like glucagon can be considered, but initial and typical management focuses on fluids, atropine, and supportive care, with caution about asthma history.