Propranolol for overdose

Propranolol has been studied most carefully in experiments and in clinics. It is used for ventricular tachycardia, arrhythmia caused by digitalis drug overdose, or as a result of thy-rotoxosis or excess catecholamine activity. Despite the fact that there are a number of )8-adrenoblockers, propranolol is considered the first choice of drugs although other blockers of calcium blockers can be just as effective. 

Overdoses of cocaine are often rapidly fatal, victims dying within minutes from arrhythmias, seizures, or respiratory depression. Those who survive for 3 hours usually recover fully. Intravenous administration of diazepam, propranolol, or calcium channel-blocking drugs may be the best... 

Cardiac dysrhythmias in digitalis overdose should be treated only if they are life-threatening. Phenytoin is probably the treatment of choice for ventricular tachydysrhyth-mias, but lidocaine or a beta-adrenoceptor antagonist, such as propranolol, are options. After an overdose of 300 tablets of digoxin (plasma digoxin concentration 50 ng/ml), recurrent ventricular fibrillation was successfully treated with bretylium tosylate (191). Sinus bradycardia may respond to atropine. 

A patient is admitted to the emergency department following a drug overdose. He is noted to have severe tachycardia. He has been receiving therapy for hypertension and angina. A drug that often causes tachycardia is (A) Diltiazem Guanethidine Isosorbide dinitrate Propranolol Verapamil... 

B. Do not use as single therapy for hypertension resulting from sympathomimetic overdose. Propranolol produces peripheral vascular beta-blockade, which may abolish beta-2-mediated vasodilation and allow unopposed alpha-mediated vasoconstriction, resulting in paradoxic worsening of hypertension. 

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