Propranolol in Imipramine Poisoning

Abstract

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.