Farooq Moonis, Qureshi Faisal, Kamkoum Wael, Abuzeyad Feras
Emergency Department King Hamad University Hospital Busaiteen Kingdom of Bahrain.
J Am Coll Emerg Physicians Open. 2020 Jun 11;1(5):1104-1107. doi: 10.1002/emp2.12126. eCollection 2020 Oct.
Propranolol is a highly lipid-soluble beta-receptor antagonist and propafenone is a potent class 1c anti-arrhythmic agent with strong Na-channel blockade effect. We describe a novel case of dual overdose of propafenone and propranolol resulting in hypotension, generalized seizures, and reduced level of consciousness that was successfully treated. A 52-year-old female ingested 500 mg of propranolol and 1.5 g of propafenone. The patient was brought to the emergency department (ED) and exhibited signs of systemic toxicity and reduced level of consciousness. The patient was treated as a case of combined β-blocker and propafenone toxicity using high dose insulin, NaHCO, glucagon, atropine, and dopamine. She started improving and becoming more alert, with subsequent ECGs revealing normal sinus rhythm. The patient was discharged 4 days later. We believe that early administration of NaHCO should be administered in patients exhibiting signs of Na-channel blockade.
普萘洛尔是一种高度脂溶性的β受体拮抗剂，普罗帕酮是一种强效的1c类抗心律失常药物，具有强大的钠通道阻滞作用。我们描述了一例因同时过量服用普罗帕酮和普萘洛尔导致低血压、全身性癫痫发作和意识水平降低，但最终成功治愈的病例。一名52岁女性摄入了500毫克普萘洛尔和1.5克普罗帕酮。该患者被送往急诊科（ED），表现出全身中毒症状和意识水平降低。该患者被作为β受体阻滞剂和普罗帕酮联合中毒病例进行治疗，使用了高剂量胰岛素、碳酸氢钠、胰高血糖素、阿托品和多巴胺。她开始好转并变得更加清醒，随后的心电图显示为正常窦性心律。患者4天后出院。我们认为，对于出现钠通道阻滞迹象的患者应尽早给予碳酸氢钠治疗。
