Sympathomimetics

Intravenous propranolol reverses hypertension after sympathomimetic overdose: two case reports

Hypertension is a potential complication following ephedrine and pseudoephedrine overdoses. Treatment with propranolol, a beta blocker, is not recommended since it may produce be an alpha agonist with the potential for further elevated blood pressure. Two patients who developed hypertension following sympathomimetic overdoses were treated with propranolol. After ingesting 4500 mg of pseudoephedrine, a 24 year-old male developed a blood pressure of 220/108. Five min after intravenous propranolol 1 mg BP was 153/88. After ingesting 17,500 mg of ephedrine a 29 year-old female developed a BP of 168/106. Her BP was 124/90 five min after intravenous propranolol. Further study is needed to investigate the potential therapeutic benefit of propranolol in the treatment of sympathomimetic-induced hypertension.