Paramedic National Registry Practice

In the case of a beta blocker overdose, which substance is commonly administered for treatment?

1. Atropine

2. Glucagon

3. Activated charcoal

4. Calcium gluconate

The correct answer is: Glucagon

In the management of beta blocker overdose, glucagon is commonly administered due to its specific pharmacological actions that counteract the effects of beta blockers. Beta blockers work by blocking the beta-adrenergic receptors, which reduces heart rate and contractility, leading to potential bradycardia and hypotension. Glucagon acts independently of the beta-adrenergic receptors, primarily increasing heart rate and contractility, and can help restore cardiac function during an overdose. It stimulates the production of cAMP, which enhances myocardial contractility and heart rate, effectively counteracting the negative cardiovascular effects caused by the beta blockers. While other treatments like atropine, activated charcoal, and calcium gluconate may be used in various clinical situations, they do not provide the same level of efficacy for addressing the specific issues presented in a beta blocker overdose. Atropine can be used for bradycardia but may not be effective if the bradycardia is severe or resistant to atropine alone. Activated charcoal is utilized for gastrointestinal decontamination but does not treat the cardiovascular effects directly. Calcium gluconate can be useful in certain scenarios, particularly in calcium channel blocker overdoses, but it is not the first-line treatment for beta blocker toxicity.