Kenyon C J, Aldinger G E, Joshipura P, Zaid G J
Department of Emergency Medicine, Saint Francis Hospital, Evanston, Illinois.
Ann Emerg Med. 1988 Jul;17(7):711-3. doi: 10.1016/s0196-0644(88)80618-8.
We present a case of attempted suicide by propranolol overdose presenting as convulsions followed by bradyasystolic cardiopulmonary arrest successfully managed by external transcutaneous pacing. Inotropic support and the resulting clinical improvement permitted discontinuation of cardiac pacing after 75 minutes. Pharmacologic management included glucagon late in the patient's management when the persistent hypotension was established to be due to beta adrenergic blockade. A serum propranolol level of 2,331 ng/mL verified the overdose. This is the first report of successful transcutaneous pacing for beta adrenergic antagonist poisoning.
我们报告一例因过量服用普萘洛尔企图自杀的病例，患者表现为惊厥，随后发生缓慢性心搏停止性心肺骤停，通过体外经皮起搏成功救治。强心支持及由此带来的临床改善使心脏起搏在75分钟后得以停止。药物治疗包括在患者病情后期，当确定持续性低血压是由β肾上腺素能阻滞所致时使用胰高血糖素。血清普萘洛尔水平为2331 ng/mL证实了药物过量。这是首例关于经皮起搏成功治疗β肾上腺素能拮抗剂中毒的报告。
