Pharmacology · Cardiovascular Drugs (Antihypertensives, Anti-Anginals, Heart Failure, Anti-Arrhythmics)

A 68-year-old woman with atrial fibrillation on atenolol for rate control is brought to the emergency department with severe bradycardia and hypotension after an accidental overdose. Which antidote is most appropriate?

  • A Calcium gluconate
  • B Glucagon
  • C Atropine
  • D Naloxone
Correct answer: B. Glucagon

Explanation

Glucagon is the antidote for beta-blocker overdose; it activates adenylyl cyclase independently of beta-receptors, increasing cAMP and reversing bradycardia and hypotension. Calcium gluconate is used for calcium channel blocker toxicity. Atropine may be used for bradycardia but does not reverse beta-blockade. Naloxone is for opioid overdose.

Reference: Goldfrank's Toxicologic Emergencies, 11th ed.

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