What is the role of beta-blockers in the ED treatment of caffeine toxicity?

Updated: Oct 24, 2020
  • Author: David Yew, MD; Chief Editor: Michael A Miller, MD  more...
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Because caffeine overdose is a situation of catecholamine excess, the use of beta-blockers raises the theoretical concern that unopposed alpha stimulation could precipitate a hypertensive crisis (similar to beta-blockade in patients with pheochromocytoma). In practice, a hypertensive crisis as a consequence of unopposed alpha stimulation has never been reported in cases of caffeine toxicity, and alpha-agonists (eg, phenylephrine) may be needed to support blood pressure in hypotensive patients. In theory, beta-blockade can be beneficial in patients with refractory hypotension and could be used in consultation with the regional poison control center or board-certified toxicologist.

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