Bisoprolol
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Severe hypoglycaemia: case report A 34-year-old woman developed severe hypoglycaemia during treatment with bisoprolol for systemic arterial hypertension. The woman was hospitalised with left hemiplegia and altered consciousness, which had started 3 hours prior to the admission. Her medical history was significant for well-controlled systemic arterial hypertension for which she had been receiving bisoprolol [dosage and route not stated]. She was heavily addicted to cannabis and reported to have smoked three cannabis cigarettes few hours prior to admission. On admission, a brain CT scan followed by CT angiography confirmed the diagnosis of malignant middle cerebral artery ischaemic stroke. Additionally, she developed oedema of right cerebral hemisphere. However, her blood glucose level dropped significantly two hours following the admission, and she developed severe hypoglycaemia [duration of treatment to reaction onset not stated]. She was under the combined influence of bisoprolol and cannabis at admission. Toxicological screening revealed presence of cannabis metabolite in blood known to cause hypoglycaemia. However, presence of bisoprolol inhibited counter-regulatory mechanism of the system to regain glycaemic control, and she developed severe hypoglycaemia secondary to bisoprolol. The woman was treated with glucose; however, significant improvement in her blood glucose level was not observed. She was then administered a second dose two hours following the first administration. Additionally, she received glucose [dextrose] for the following 14 hours. Thereafter, her blood glucose level stabilised. Hantson P, et al. Severe hypoglycemia following massive ischemic stroke in a cannabis-addicted patient treated by a beta-blocking agent. Minerva Anestesiologica 85: 803498084 1038-1039, No. 9, Sep 2019. Available from: URL: http://doi.org/10.23736/S0375-9393.19.13659-0
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Reactions 29 Aug 2020 No. 1819
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