Management of Severe Beta-Blockers Toxicity with High Dose Insulin Euglycemic Therapy: A Case Report

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Published Jul 13, 2020
DOI https://doi.org/10.9734/ijmpcr/2020/v13i130113
    Page: 24-28

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K. Hussein
Beaumont Hospital, Dublin, Ireland.
A. Neill
Beaumont Hospital, Dublin, Ireland.
S. Galvin
Beaumont Hospital, Dublin, Ireland.

Abstract

Aims: Highlighting the efficacy of early initiation of high dose insulin therapy in Beta-blockers overdose over conventional therapy.

Presentation of Case: Authors describe the successful treatment of severe bisoprolol-induced cardiogenic shock in a 74-year-old man using high dose insulin euglycemic therapy. He received intravenous bolus of 1IU/kg of actarapid insulin followed by intravenous infusion of 0.5 IU/kg/hour. The patient hemodynamic parameters improved dramatically within few hours after starting the insulin therapy.

Discussion: Beta-blockers overdose can lead to significant morbidity and mortality due to the often-associated vasopressor-resistant shock. high dose insulin euglycemic therapy is a potential emerging therapy for beta-blockers toxicity with support in the literature from several animal studies, case reports and expert opinion.

Conclusion: High dose insulin euglycemic therapy is a safe and effective method in reversing the hemodynamic consequences induced by beta-blockers overdose and should be used early in the treatment.

Keywords:
Beta-blockers, cardiogenic shock, inotropes, insulin, case report.

Article Details

How to Cite
Hussein, K., Neill, A., & Galvin, S. (2020). Management of Severe Beta-Blockers Toxicity with High Dose Insulin Euglycemic Therapy: A Case Report. International Journal of Medical and Pharmaceutical Case Reports, 13(1), 24-28. https://doi.org/10.9734/ijmpcr/2020/v13i130113
Issue
2020 - Volume 13 [Issue 1]
Section
Case Report

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