What is the primary treatment for a beta-blocker overdose?

In cases of beta-blocker overdose, glucagon is identified as the primary treatment due to its unique ability to counteract the cardiovascular effects caused by beta-blockers. Glucagon works by activating adenylate cyclase via binding to glucagon receptors, which leads to increased cyclic AMP levels in cardiac myocytes. This results in improved heart contractility and increased heart rate, counteracting the negative inotropic and chronotropic effects typically induced by beta-blockade.

Additionally, glucagon can help manage refractory hypotension that often accompanies a beta-blocker overdose. It is particularly advantageous because it does not necessitate beta-receptor availability to exert its effects, unlike catecholamines (which are less effective when beta-blockade is present).

Other treatments, while potentially useful in specific situations, do not address the core issues caused by beta-blocker toxicity as effectively as glucagon does. For instance, insulin can play a role in managing hyperglycemia and has been used in cases of severe toxicity, but it does not directly counteract the cardiovascular effects of beta-blockade. Calcium gluconate is primarily used to address calcium channel blocker toxicity rather than beta-blocker toxicity. Activated charcoal might be beneficial for decontaminating the gastrointestinal tract but would not reverse