December 1973

Propranolol in Imipramine Poisoning

Author Affiliations

From the departments of pediatrics and medicine, Mercy Catholic Medical Center, Philadelphia. Dr. Snyder is now a pathology resident at the Hospital of the University of Pennsylvania, Philadelphia.

Am J Dis Child. 1973;126(6):847-849. doi:10.1001/archpedi.1973.02110190689023

A 26-month-old girl ingested 250 mg of imipramine hydrochloride (Tofranil). She developed respiratory arrest, convulsions, coma, and four episodes of cardiac asystole and had eight episodes of ventricular fibrillation. Propranolol hydrochloride (Inderal) effectively converted the fibrillation to normal sinus rhythm after seven failures with the use of direct-current defibrillation. Continuous gastric lavage, mechanical ventilation, and symptomatic therapy contributed to a favorable outcome.