Journal of The Korean Society of Clinical Toxicology (대한임상독성학회지)

Korean society of Clincal Toxicology (대한임상독성학회)
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The Intoxication of Beta Blocker with Psychiatric Drugs Focused on the Cardiovascular Adverse Effects

베타차단제를 포함한 정신과적 약물 중독: 심혈관계 영향을 중심으로

  • Joo, Sung Woo (Department of Emergency Medicine, School of Medicine, Ajou University) ;
  • Min, Young-Gi (Department of Emergency Medicine, School of Medicine, Ajou University) ;
  • Choi, Sang-Cheon (Department of Emergency Medicine, School of Medicine, Ajou University) ;
  • Park, Eun Jung (Department of Emergency Medicine, School of Medicine, Ajou University)
  • 주성우 (아주대학교 의과대학 응급의학교실) ;
  • 민영기 (아주대학교 의과대학 응급의학교실) ;
  • 최상천 (아주대학교 의과대학 응급의학교실) ;
  • 박은정 (아주대학교 의과대학 응급의학교실)
  • Received : 2016.06.30
  • Accepted : 2016.08.08
  • Published : 2016.12.31
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Abstract

Purpose: Beta blocker (BB) has been prescribed for anxiety and panic disorder. Patients intoxicated by psychiatric drugs have often been exposed to BB. Moreover, BB overdose has adverse effects including cardiovascular effects, which can be life-threatening. This study was conducted to identify the characteristics of BB intoxication with psychiatric drugs and the adverse effects on the cardiovascular system. Methods: A single center, retrospective study was performed from January 2010 to December 2015. A total of 4,192 patients visited the emergency department (ED) with intoxication, and 69 with BB intoxication were enrolled. Results: Overall, 64 patients (92.8%) of enrolled patients were intoxicated with drugs prescribed for the purpose of psychiatric disorders. Propranolol was the most common BB (62 cases, 96.2%), and the median dose was 140.0 mg (25%-75% 80.0-260.0). Twenty-four patients (37.5%) had experienced cardiovascular events, and these patients tended to have decreased mentality, hypotension and coingestion with quetiapine. An initial mean arterial pressure (MAP) below 65 mmHg (odds ratio 10.069, 95% confidence interval 1.572-64.481, p=0.015) was identified as a factor of cardiovascular event upon multiple logistic regression analysis. Conclusion: Initial MAP below 65 mmHg was a factor of cardiovascular adverse effect in patients of BB intoxication with psychiatric drugs.

Keywords

References

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