Seizures and Irreversible Cardiogenic Shock Following Propranolol Poisoning: Report of 2 Cases and Literature Review

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Abstract
Propranolol, a β-blocker (BB), is one of the drugs that can be misused for suicide. The clinical manifestations of overdose can range from asymptomatic to neurological symptoms such as seizures and loss of consciousness, cardiac shock, and even death. Herein, we describe 2 cases that were referred to our hospital’s emergency department in northern Iran: The first case was a 37-year-old woman who suffered from a decreased level of consciousness, bradycardia, and hypotension after ingesting 4 g of propranolol tablets. In the second case, a 32-year-old woman was admitted with complete cardiac arrest and a suspected history of ingesting 4.8 g of propranolol pills a few hours before admission. Therefore, the time interval between pill intake and treatment initiation seems to be one of the most important factors in prognosis, in addition to the number and dosage of pills ingested.

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