Overdose : מינון יתר

4.9   Overdose

If overdosage occurs, the following measures should be considered:
1.   Gastric lavage, if ingested. Studies have shown that timolol does not dialyse readily.

2.   Symptomatic bradycardia: atropine sulphate, 0.25 to 2 mg intravenously, should
be used to induce vagal blockade. If bradycardia persists, intravenous isoprenaline hydrochloride should be administered cautiously. In refractory cases, the use of a cardiac pacemaker may be considered.

3.   Hypotension: a sympathomimetic pressor agent such as dopamine, dobutamine or noradrenaline should be used. In refractory cases, the use of glucagon has been reported to be useful.

4.   Bronchospasm: isoprenaline hydrochloride should be used. Additional therapy with
aminophylline may be considered.



5.   Acute cardiac failure: conventional therapy with digitalis, diuretics, and oxygen should be instituted immediately. In refractory cases, the use of intravenous aminophylline is suggested. This may be followed, if necessary, by glucagon, which has been reported useful.

6.   Heart block (second- or third-degree): isoprenaline hydrochloride or a pacemaker should be used.