#Glucagon beta blocker antidote skin
Expiratory wheezes were heard, and the skin was cold and mottled. The level of consciousness varied from unresponsiveness to combativeness. The electrocardiogram showed sinus rhythm at a rate between 40 and 50 beats/min. Despite a total of 2 mg atropine, 1 mg glucagon, and 1,900 ml crystalloid, systolic blood pressure remained less than 80 mmHg. Two hours after admission, the patient collapsed while having a bowel movement. Electrocardiogram and oscillometric blood pressure monitoring were instituted, and for the next 90 min, a sinus rhythm at a rate of 60 beats/min and blood pressure between 110/70 mmHg and 120/80 mmHg were observed. Gastric lavage was instituted without recovery of tablet fragments. Routine toxicologic screening was negative. Laboratory data revealed sodium 141 mmol/L, potassium 4.9 mmol/L, chloride 104 mmol/L, HCO 318 mmol/L, blood urea nitrogen 12 mg/dL (4.28 mmol/l), creatinine 1.2 mg/dL (106 micro mol/L), glucose 116 mg/dL (6.44 mmol/l), and hemoglobin 160 g/l. An electrocardiogram showed sinus rhythm with a ventricular rate of 72 beats/min. Physical examination was otherwise unremarkable. Blood pressure was 130/80 mmHg, heart rate was 72 beats/min, respiratory rate was 24 breaths/min, and tympanic temperature was 36.6 degrees Celsius. On arrival, he was alert and cooperative. A 50-yr-old, 98-kg man with a history of depression, coronary artery disease, hypertension, and asthma was brought to the our institution's emergency department after having allegedly ingested 20 atenolol tablets (50 mg/tablet) 30 min earlier.
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