Punol Overdosage

Symptoms: The effect of overdosage are expected to be primarily related to fenoterol hydrobromide.
The expected symptoms with overdosage are those of excessive beta-adrenergic stimulation, the most prominent being tachycardia, palpitation, tremor, hypertension, hypotension, angina pain, arrhythmias, seizures, hypokalemia and hyperglycemia.
Acute overdosage of ipratropium bromide is unlikely following oral inhalation because of topical administration and poor absorption of ipratropium bromide. The overdosage of ipratropium bromide may expected to produce effects associated with antimuscarinic administration such as dry mouth, visual accommodation disturbances.
Treatment: The drug should be discontinued and appropriate symptomatic and supportive therapy should be initiated. Monitor blood pressure and ECG. The judicious use of a cardioselective β-receptor blocker (i.e., metroprolol, atenolol) is suggested, bearing in mind the danger of inducing an asthmatic attack. Dialysis is not appropriate.