From the FDA Drug Label
OVERDOSAGE ... Bronchospasm Administer a beta 2-stimulating agent and/or a theophylline derivative.
- Albuterol is a beta 2-stimulating agent.
- It can be given for bronchospasm caused by a metoprolol overdose. 1
From the Research
No, albuterol should not be given for metoprolol overdose. The preferred treatment for beta-blocker overdose like metoprolol is glucagon, which works through a different mechanism than beta-blockers. Albuterol is a beta-agonist that primarily affects beta-2 receptors in the lungs, while metoprolol blocks beta-1 receptors in the heart. Using albuterol could potentially worsen the situation by causing additional cardiovascular stress without effectively reversing the beta-blockade.
Treatment Options
For metoprolol overdose, treatment typically includes:
- Supportive care
- Activated charcoal if the ingestion was recent
- Intravenous fluids
- Atropine for bradycardia
- Vasopressors for hypotension
- Glucagon (initial bolus of 5-10 mg IV followed by infusion of 1-5 mg/hour) to increase heart rate and contractility In severe cases, high-dose insulin with glucose therapy, calcium, and even extracorporeal membrane oxygenation might be necessary, as seen in a case where a patient was successfully treated with high-dose insulin therapy 2. This is a medical emergency requiring immediate hospital care and management by healthcare professionals. According to a study published in 2015, intravenous lipid emulsion and hyperinsulinemia/euglycemia therapy can also be effective in treating metoprolol overdose 3. Another study from 2017 highlights the potential utility of extracorporeal life support in cases of severe toxicity due to multiple cardioactive medications, including metoprolol 4.