Metoprolol overdose symptoms
Pro Research Analysisby 
Searched over 200M research papers
Symptoms of Metoprolol Overdose
Metoprolol, a beta-blocker commonly used to treat hypertension and arrhythmias, can lead to severe and potentially life-threatening symptoms when taken in excessive amounts. This article synthesizes findings from multiple case studies and research papers to outline the primary symptoms and clinical considerations associated with metoprolol overdose.
Cardiovascular Symptoms: Bradycardia and Hypotension
One of the most prominent symptoms of metoprolol overdose is bradycardia, a condition characterized by an abnormally slow heart rate. This symptom is frequently accompanied by hypotension, or low blood pressure, which can lead to cardiovascular collapse if not promptly treated 125. In severe cases, patients may experience sudden and rapid clinical deterioration, necessitating close and careful monitoring .
Central Nervous System Effects: Delirium and Psychosis
Although less common, metoprolol overdose can also affect the central nervous system. Neuropsychiatric adverse reactions such as acute delirium and psychosis have been documented, even in young patients taking low doses of the drug . These symptoms typically resolve within a few days after discontinuation of metoprolol, but they highlight the need for physicians to be vigilant for such reactions in both elderly and younger patients.
Resistance to Standard Treatments: Hypotension and Oliguria
In some cases, patients with metoprolol overdose may exhibit hypotension and oliguria (reduced urine output) that are resistant to standard cardiotonic drugs and volume loading. These patients may require unusually high doses of inotropic and chronotropic agents for resuscitation . This resistance underscores the complexity of managing severe metoprolol toxicity and the need for specialized treatment protocols.
Myocardial Ischemia and Dysrhythmia
Patients with pre-existing coronary artery disease are at particular risk of myocardial ischemia and dysrhythmia following a metoprolol overdose. One case study reported a patient who developed acute myocardial infarction (AMI) characterized by ST segment elevation and elevated cardiac markers after ingesting a large dose of metoprolol . This case emphasizes the potential for metoprolol poisoning to trigger significant cardiac events in vulnerable individuals.
Treatment and Management
The management of metoprolol overdose typically involves initial gastric lavage followed by the administration of antidotes such as glucagon, which is considered a first-line treatment for beta-blocker toxicity . Continuous cardiac monitoring and random blood sugar monitoring are also essential components of patient care. In cases of deliberate overdose, psychiatric counseling and nursing care are crucial for comprehensive treatment .
Conclusion
Metoprolol overdose presents a range of serious symptoms, primarily affecting the cardiovascular and central nervous systems. Bradycardia, hypotension, delirium, and resistance to standard treatments are common challenges in managing these cases. Emergency physicians must be prepared to address these symptoms promptly and effectively, particularly in patients with underlying cardiac conditions.
Sources and full results
Most relevant research papers on this topic