Mandatory psychiatric or mental health follow-up arranged
Attend all scheduled appointments
Contact crisis line if thoughts of self-harm recur
Medication safety
Store all medications in a locked cabinet or away from access
Ask your prescriber about receiving smaller quantities at a time
Primary care or clinic follow-up
Within 1 to 2 days of discharge
Medication review with your regular physician
Safety planning for medication access
Poison Control: 1-800-222-1222 for any questions at home
References
Guidelines and key sources
AHA 2025 Guidelines
Cao D, Arens AM, Chow SL et al. Part 10: Adult and Pediatric Special Circumstances of Resuscitation: 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care. Circulation. 2025.
Primary reference for high-dose insulin, ECMO, and vasopressor recommendations in beta-blocker toxicity
AHA 2023 Focused Update
Lavonas EJ, Akpunonu PD, Arens AM et al. 2023 American Heart Association Focused Update on the Management of Patients With Cardiac Arrest or Life-Threatening Toxicity Due to Poisoning. Circulation. 2023.
Activated charcoal and decontamination guidance; antidote escalation framework
ACC/AHA/HRS 2018 Bradycardia Guideline
Kusumoto FM, Schoenfeld MH, Barrett C et al. 2018 ACC/AHA/HRS Guideline on The Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay. Heart Rhythm. 2019.
Rotella JA, Greene SL, Koutsogiannis Z et al. Treatment for Beta-Blocker Poisoning: A Systematic Review. Clinical Toxicology. 2020.
Evidence synthesis for high-dose insulin, glucagon, calcium, and lipid emulsion
High-dose insulin: best hemodynamic evidence among antidotes
ILE: insufficient evidence to recommend in beta-blocker overdose
Hu Y, Mujahid K, Ahsan A et al. Effectiveness of Treatments for Propranolol Toxicity: A Systematic Review. European Journal of Clinical Pharmacology. 2026.
Propranolol-specific evidence for combined insulin, vasopressors, bicarbonate, and ECMO
Lauterbach M. Clinical Toxicology of Beta-Blocker Overdose in Adults. Basic and Clinical Pharmacology and Toxicology. 2019.
Agent-specific pharmacokinetics; dialysis evidence for water-soluble agents
Additional references
Suarez F, Koyfman A, Long B. Pearls and Pitfalls for the Emergency Clinician: Beta Blocker and Calcium Channel Blocker Toxicity. The Journal of Emergency Medicine. 2026.
Emergency department approach; pitfall avoidance
Graudins A, Lee HM, Druda D. Calcium Channel Antagonist and Beta-Blocker Overdose: Antidotes and Adjunct Therapies. British Journal of Clinical Pharmacology. 2016.
Antidote mechanisms and practical dosing guidance
Tisdale JE, Chung MK, Campbell KB et al. Drug-Induced Arrhythmias: A Scientific Statement From the American Heart Association. Circulation. 2020.
Sotalol QT prolongation and torsades management framework
ICD-10 coding
T44.7: poisoning by beta-adrenoreceptor antagonists, initial encounter
T44.7XXA intentional self-harm
T44.7XXS sequelae
SymptomDx is an educational tool for medical professionals. It does not replace clinical judgment. Verify all clinical data and drug dosages with authoritative sources.