UMEM Educational Pearls

Category: Toxicology

Title: Toxin-Induced Bradycardia with Hypotension

Keywords: bradycardia, hypotension, beta blocker, calcium channel blocker, clonidine (PubMed Search)

Posted: 7/7/2010 by Bryan Hayes, PharmD (Emailed: 7/8/2010) (Updated: 12/9/2022)
Click here to contact Bryan Hayes, PharmD

In a patient with toxin-induced bradycardia and hypotension, here is a quick differential to help identify the responsible substance:

  • Beta blockers
  • Calcium channel blockers
  • Cholinergics
  • Clonidine (and other alpha-2 agonists)
  • Digoxin (and other cardiac glycosides)
  • Opioids
  • Sedative hypnotics (such as benzodiazepines and barbiturates)

Less commonly seen causes include: magnesium, propafenone, and plant toxins (aconitine, andromedotoxin, veratrine).