Acebutolol-induced ventricular tachycardia reversed with sodium bicarbonate.
BACKGROUND
Acebutolol is a unique beta blocker that possesses cardioselectivity, partial agonist activity, and membrane stabilizing activity. Sodium bicarbonate is used to reverse the cardiotoxic effects of other drugs with membrane stabilizing activity. There have been no reported cases of acebutolol-induced ventricular dysrhythmias treated successfully with bolus sodium bicarbonate.


METHODS
A 48-year-old man ingested approximately 6.4 g of acebutolol with ethanol (blood ethanol 61 mmol/L). There were no other coingestants identified. One hour after presentation, the patient had a cardiac arrest with the monitor showing ventricular tachycardia. Sodium bicarbonate 50 mEq intravenous push converted the patient to sinus rhythm and the blood pressure improved to 129/90 mm Hg.


CONCLUSIONS
This case demonstrates a temporal relationship between bolus sodium bicarbonate administration and the termination of acebutolol-induced ventricular tachycardia.
Donovan
K D
KD
University of Western Ontario and London Health Sciences Centre.
Gerace
R V
RV
Dreyer
J F
JF
D000070:Acebutolol / Q000506:poisoning*; D000889:Anti-Arrhythmia Agents / Q000506:poisoning*; D004336:Drug Antagonism; D004562:Electrocardiography / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D017693:Sodium Bicarbonate / Q000008:administration & dosage / Q000627:therapeutic use*; D013610:Tachycardia / Q000139:chemically induced*; D013997:Time Factors
D000889:Anti-Arrhythmia Agents; D000070:Acebutolol; D017693:Sodium Bicarbonate