Adrenergic Storm - Treatment

Treatment

If an overdose by ingestion is suspected, the patient should be given gastric lavage, activated charcoal, or both; this could make the difference between life and death in a close situation, but it should be avoided unless there is evidence of overdose as it can aggravate the patient.

The first line treatments are diazepam and a non-selective beta blocker; other antihypertensive drugs may also be used. Not all benzodiazepines and beta blockers are safe to use in an adrenergic storm; for instance, alprazolam and propranolol; alprazolam weakly agonizes dopamine receptors and causes catecholamine release while propranolol mildly promotes some catecholamine release.

After bringing the heart rate and blood pressure down, treatment is supportive; if there is an underlying condition causing the adrenergic storm, then that must be addressed. However, many cases of adrenergic storms are completely idiopathic in nature; indeed, they are a poorly understood phenomena.

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