pattern and management of antihypertensive drug toxicity among admitted patients to alexandria poison center, egypt

Background: despite different antidotes, antihypertensive toxicity, especially beta-blockers (bb) and calcium channel blockers (ccb), have a significant morbidity and mortality. this study aimed to determine the prevalence and characteristics of antihypertensive toxicity among the admitted patients to alexandria poison center (apc).method: a cross-sectional study was carried out on all patients with antihypertensive toxicity, admitted to apc throughout year 2022. the management plan with adding methylene blue (mb) as a single bolus dose of 1mg/kg over 10 min to shocked cases was assessed.  results: this work included 105 patients; with a mean age of (23.3 ± 13.3 years), (22.9%) were males and (77.1%) were females. the majority ingested bb and ccb. ecg showed bradycardia (8.6%), prolonged qtc (11.4%), prolonged pr interval (9.5%) and wide qrs complex (1.9%). of all patients, (8.6%) received atropine, (4.8%) received vasopressors, (7.6%) received intravenous (iv) calcium and (4.8%) received high insulin glucose. in the current work, two cases presented with shock (1.9%) received iv mb early and survived. refractory shock was the cause of death in (1.9%) of the cases who died before starting mb. the mean length of hospital stay was 34.06 ± 21.42 hours.  ingestion of antihypertensive agents from different classes and prolonged pr interval were the main predictors of the length of hospital stay where p = 0.012, 0.021 at 95% ci respectively.conclusion: beta-blockers were the commonest ingested antihypertensive agent. simultaneous ingestion of antihypertensive agents from different classes and prolonged pr interval have a significant prediction of the hospital stay length.