Hemodialysis in Beta Blocker overdose

Q: Hemodialysis is recommended in which of the refractory case of which of the Beta Blockers?

A) Metoprolol
B) Propranolol 
C) Timolol 
D) Atenolol
E) All of the above


Answer: D

Beta-blocker overdose is tricky in the sense that hemodialysis will work only with hydrophilic and minimally protein-bound beta blockers. These include atenolol, nadolol, sotalol and acebutolol. Unfortunately, commonly used beta blockers such as metoprolol, propranolol, and timolol do not get removed by hemodialysis.

#toxicology


Reference: 

DeLima LG, Kharasch ED, Butler S. Successful pharmacologic treatment of massive atenolol overdose: sequential hemodynamics and plasma atenolol concentrations. Anesthesiology 1995; 83:204.