Q: 52 year old male presented with Propranolol (Beta blocker) overdose. While writing orders for glucagon, which of the following medicine is recommended to administer concurrently?
A) Anti-emetic
B) Antibiotics
C) Steroids
D) Calcium channel blockers
E) Anti-seizure
Answer: A
Glucagon administration can induce severe emesis and it is recommended to administer a serotonin antagonist antiemetic such as ondansetron as a prophylaxis. Similarly diarrhea can also become an issue and patient may require anti-diarrheal but it is not recommended to administer concurrently with beta blocker.
Steroids, antibiotics and anti-seizure drugs have no role in beta blocker overdose.
Calcium channel blockers may make hypotension and bradycardia worse due to beta blocker overdose.
#toxicology
#pharmacology
References:
1. Ranganath L, Schaper F, Gama R, Morgan L. Mechanism of glucagon-induced nausea. Clin Endocrinol (Oxf). 1999 Aug;51(2):260-1.
2. Bettge K, Kahle M, Abd E, Aziz MS, Meier JJ, Nauck MA. Occurrence of nausea, vomiting and diarrhoea reported as adverse events in clinical trials studying glucagon-like peptide-1 receptor agonists: A systematic analysis of published clinical trials. Diabetes Obes Metab. 2017 Mar;19(3):336-347. Epub 2016 Dec 19.
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