Atenolol overdose successfully treated with hemodialysis-a case report

Atenolol is a cardio selective beta-blocker and its toxicity often leads to severe hemodynamic instability and contributes to mortality. A significant number of fatal poisonings are caused by beta blockers and supportive therapy is the cornerstone of treatment. We report a case of atenolol toxicity, who had bradycardia and severe hypotension. The patient was administered with high dose insulin therapy, glucagon infusion, lipid emulsion therapy and vasopressors to maintain the mean arterial pressure (MAP) and normal heart rate. Despite these, the patient did not show any clinical improvement. Owing to the favourable hydrophilic and pharmacokinetic characteristics of atenolol, we have administered hemodialysis treatment, with which subsequent improvement in hemodynamic and clinical parameters were observed. The management of atenolol overdose was thus successful with hemodialysis.