A case of massive atenolol overdose successfully managed with intravenous calcium chloride

Atenolol has been widely used owing to its unique beta-adrenoceptor selectivity and favourable safety profile although overdose cases have been reported associated with its use. We report a 50-year-old man with hypertension who allegedly ingested 1 g of immediate-release atenolol. He presented with hypotension and other clinical manifestations of decreased tissue perfusion such as metabolic acidosis and oliguria in the absence of bradycardia. The patient was given activated charcoal and his hypotension was managed with continuous fluid resuscitation, intravenous inotropes and vasopressors. Despite these, he remained hypotensive until the administration of calcium chloride then which subsequent improvements in hemodynamic and metabolic parameters were observed. The patient recovered without any complications. In conclusion, calcium chloride can be used as an adjunct treatment of beta blocker overdose unresponsive to conventional treatments.