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Beta-blocker overdose — ABEM Board MCQ

Instant feedback + full explanation. One question, done properly.

HardToxicologyBeta-blocker overdoseABEM Board

A 59-year-old man presents as triage level 1 after ingesting extended-release metoprolol. BP is 72/38 mm Hg, HR 38/min, glucose is 62 mg/dL, and he remains hypotensive after atropine and fluids. Which of the following is the most appropriate next step in management?

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Correct answer: E — High-dose insulin euglycemia therapy with vasopressors as needed

Severe beta-blocker toxicity often requires high-dose insulin euglycemia therapy, vasopressors, and adjuncts such as glucagon or lipid therapy in refractory cases.

Reference: ACMT beta-blocker toxicity guidance; ABEM EM Model