Wednesday, May 9, 2018

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.



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

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