Berodual Overdosage

Symptoms: The effects of overdosage are expected to be primarily related to fenoterol.
The expected symptoms are those of excessive β-adrenergic stimulation, the most prominent being tachycardia, palpitation, tremor, hypertension, hypotension, widening of the pulse pressure, anginal pain, arrhythmias and flushing.
Metabolic acidosis and hypokalemia have also been observed with fenoterol when applied in doses higher than recommended for the approved indications of Berodual. Expected symptoms of overdosage with ipratropium bromide (eg, dry mouth, visual accommodation disorder) are mild because the systemic availability of inhaled ipatropium is very low.
Treatment: Treatment with Berodual should be discontinued. Acid base and electrolyte monitoring should be considered.
Administration of sedatives and tranquilizers, or in severe cases, intensive care treatment.
Beta-receptor blockers, preferably β₁-selective, are suitable as specific antidotes; however, a possible increase in bronchial obstruction must be taken into account and the dose should be adjusted carefully in patients suffering from bronchial asthma or COPD because of the risk of precipitating severe bronchospasm, which may be fatal.