SalioSAM/toxsample11 huggingface dataset:
Poisoning cause: SEVERE Duloxetine (Cymbalta) TOXICITY
Toxic dose : Symptoms such as somnolence, coma, serotonin syndrome, seizures, syncope, tachycardia, hypotension, hypertension, and vomiting have been reported at doses starting from 1000 mg.
Management: •Severe serotonin syndrome requires aggressive benzodiazepines and serotonin antagonists. •For muscle rigidity, hyperthermia, and severe cases, intubation, paralysis, ventilation, and cooling are crucial. •Treat hypotension with IV fluids initially; vasopressors if needed. •Seizures: benzodiazepines; barbiturates or propofol for recurrences. •Wide-complex dysrhythmias: sodium bicarbonate boluses (1 to 2 mEq/kg) targeting pH 7.45 to 7.55. •Torsade de pointes is rare; standard interventions include magnesium sulfate and pacing.
Clinical effect 1: Serotonin syndrome
Clinical effect 2: CNS depression
Clinical effect 3: Neuromuscular abnormalities
Clinical effect 4: Autonomic instability
Clinical effect 5: Seizure
Clinical effect 6: Hypotension
Clinical effect 7: Coma
Poisoning cause: MILD TO MODERATE Dextromethorphan toxicity
Toxic dose : Over 7.7 mg/kg (acute)
Management: Treatment is symptomatic and supportive. Control agitation and confusion with benzodiazepines.
Clinical effect 1: Drowsiness/lethargy
Clinical effect 2: Ataxia
Clinical effect 3: Nystagmus
Clinical effect 4: Hyperexcitability
Clinical effect 5: Miosis
Clinical effect 6: Tachycardia
Clinical effect 7: Hypertension
Clinical effect 8: Nausea
Poisoning cause: SEVERE Dextromethorphan toxicity
Toxic dose : Over 7.7 mg/kg (acute)
Management: Treatment is symptomatic and supportive. Treat agitation with benzodiazepines. Treat seizures with IV benzodiazepines; barbiturates or propofol may be needed if seizures persist or recur. Treat serotonin toxicity with benzodiazepines, and consider cyproheptadine, if symptoms persist. Severe cases may require neuromuscular paralysis. For respiratory and CNS depression, successful reversal with naloxone has been reported, but is not consistent. Orotracheal intubation may be necessary
Clinical effect 1: Toxic psychosis
Clinical effect 2: Seizure
Clinical effect 3: Coma
Clinical effect 4: Hypotension
Clinical effect 5: Respiratory depression
Poisoning cause: MILD TO MODERATE Pseudoephedrine TOXICITY
Toxic dose : Over 11 mg/kg (child under 6 years old), 180 mg (child under 6 years old)
Management: Benzodiazepines can be used for agitation, tachycardia, hypertension and psychosis. Manage mild hypotension with IV fluids
Clinical effect 1: Vomiting
Clinical effect 2: Mydriasis
Clinical effect 3: Hypertension
Clinical effect 4: Tachycardia
Clinical effect 5: Agitation/Irritability/Restlessness
Clinical effect 6: Anxiety
Clinical effect 7: Reflexive bradycardia
Clinical effect 9: Dermal reactions
Poisoning cause: SEVERE Pseudoephedrine TOXICITY
Toxic dose : Over 11 mg/kg (child under 6 years old), 180 mg (child under 6 years old)
Management: Supportive care, including IV crystalloid, oxygen and mechanical ventilation may be required. Benzodiazepines can be used for severe agitation and psychosis. Treat dysrhythmias if they occur. Patients with focal neurologic deficits should receive a head CT to evaluate for intracranial bleeding
Clinical effect 1: Sinus dysrhythmia
Clinical effect 2: Intracranial hemorrhages
Clinical effect 3: Seizure
Clinical effect 4: Myocardial infarction (MI)
Clinical effect 5: Ischemic bowel infarction
Clinical effect 6: Psychosis
Clinical effect 7: Hypokalemia
Clinical effect 8: Drowsiness/lethargy
Poisoning cause: MILD TO MODERATE Phenylephrine TOXICITY
Toxic dose : 6 months - 23 months:	>4 mg/kg OR >60 mg,
2 years - 5 years:	>60 mg,
6 years - 11 years:	>120 mg,
12 years - 64 years:	>360 mg,
65 years - 79 years:	>120 mg
Toxic serum or urine levels: Nystagmus is common at serum concentrations above 20 mg/L, ataxia, slurred speech, and tremor above 30 mg/L
Management: Simple symptomatic care is all that is required in the vast majority of Overdoses. Hydration and benzodiazepines may be used as needed for agitation and mild vital sign abnormalities
Clinical effect 1: Vomiting
Clinical effect 2: Mydriasis
Clinical effect 3: Hypertension
Clinical effect 4: Tachycardia
Clinical effect 5: Agitation/Irritability/Restlessness
Clinical effect 6: Anxiety
Clinical effect 7: Reflexive bradycardia
Clinical effect 9: Dermal reactions
Poisoning cause: SEVERE Phenylephrine TOXICITY
Toxic dose : 6 months - 23 months:	>4 mg/kg OR >60 mg,
2 years - 5 years:	>60 mg,
6 years - 11 years:	>120 mg,
12 years - 64 years:	>360 mg,
65 years - 79 years:	>120 mg
Management: VITAL SIGNS: Fluid resuscitation should be the first-line treatment for hypotension. Hyperthermia should be treated with benzodiazepines, cooled fluids, and external cooling measures if mild, however, for temperatures Over 40 degrees Celsius, intubation and paralysis is recommended. 2) CARDIOVASCULAR: Antihypertensives can be used for severely elevated blood pressure associated with end organ effects such as myocardial ischemia or cerebrovascular ischemia. In the hypertensive tachycardic patient, one should avoid using beta-blockers in isolation due to the possibility of unopposed alpha effects worsening vasospastic ischemia. Nicardipine or labetalol are good antihypertensive choices because they have effects on both heart rate and blood pressure. Treat ventricular dysrhythmias with lidocaine or amiodarone, and cardiOversion if hemodynamically unstable. 3) NEUROLOGIC: Large doses of benzodiazepines may be needed to control profound agitation and seizures. If benzodiazepines are ineffective, propofol or phenobarbital can be used to control the symptoms. Management of cerebrovascular hemorrhage should focus on blood pressure control and airway management as appropriate. 4) RENAL: Fluid resuscitation is the key to maintaining urine output. Acidosis can be treated with normal saline (and sedation to control agitation) until euvolemia is achieved, followed by bicarbonate for persistent severe acidosis. 5) MUSCULOSKELETAL: Sedation to control agitation; fluid resuscitation and maintenance of urine output will limit progression of rhabdomyolysis
Clinical effect 1: Sinus dysrhythmia
Clinical effect 2: Intracranial hemorrhages
Clinical effect 3: Seizure
Clinical effect 4: Myocardial infarction (MI)
Clinical effect 5: Ischemic bowel infarction
Clinical effect 6: Psychosis
Clinical effect 7: Hypokalemia
Clinical effect 8: Drowsiness/lethargy
Poisoning cause: MILD TO MODERATE Vitamin D TOXICITY
Toxic dose : •Vitamin D Toxicity Can occur with prolonged intake of 50,000 to 150,000 IU daily (Acuity: Chronic).
Management: Monitor serum calcium and phosphorus concentrations. Discontinue all vitamin D and calcium supplements; start a low-calcium diet. Increase oral fluids or IV fluids, if patient is unable to tolerate fluids, to increase renal calcium clearance. Forced diuresis with IV 0.9% normal saline and furosemide can be used to promote calcium excretion. 
Clinical effect 1: Nausea
Clinical effect 2: Vomiting
Clinical effect 3: Abdominal pain
Clinical effect 4: Anorexia
Clinical effect 5: Constipation
Clinical effect 6: Diarrhea
Clinical effect 7: Weakness
Clinical effect 8: Fatigue
Clinical effect 9: Agitation/Irritability/Restlessness
Clinical effect 10: Drowsiness/lethargy
Clinical effect 11: Headache
Clinical effect 12: Dizziness
Poisoning cause: SEVERE Vitamin D TOXICITY
Toxic dose : •Vitamin D Toxicity Can occur with prolonged intake of 50,000 to 150,000 IU daily (Acuity: Chronic).
Management: HYPERCALCEMIA: Monitor serum calcium and phosphorus concentrations until levels have stabilized, discontinue all supplements, and continue forced diuresis as indicated. Corticosteroids: Hydrocortisone: 100 mg/day OR Prednisone: 40 mg/day Over 5 days can improve hypercalcemia and hypercalcuria. Bisphosphonates (eg, pamidronate 90 mg IV; alendronate, or zoledronic acid (limited data) have been used successfully to treat severe hypercalcemia. Calcitonin has also been used. Hemodialysis may be indicated in patients with severe hypercalcemia that is unresponsive to other treatment. Cardiac dysrhythmias may develop, obtain a baseline ECG and continuous cardiac monitoring. SEIZURES: Treat initially with benzodiazepines, followed by barbiturates as needed. OTHER: Monitor CNS and renal function
Clinical effect 1: Seizure
Clinical effect 2: Confusion
Clinical effect 3: Ataxia
Clinical effect 4: Psychotic disturbances
Clinical effect 5: Coma
Clinical effect 6: Renal failure
Clinical effect 7: Dysrhytmia
Clinical effect 8: Polyuria
Clinical effect 9: Polydipsia
Poisoning cause: Vilazodone TOXICITY
Toxic dose : •Toxic dose of Vilazodone in a Child: Young children can experience severe toxicity with Vilazodone doses as low as 10 mg.
•Toxic dose of Vilazodone in adults: (Over 200 mg ).Should be observed for ingestions exceeding 200 mg of Vilazodone.
Management: 1.Most patients need supportive care. 2.Manage agitation and confusion with benzodiazepines (first-line therapy). 3.Hypertension and tachycardia are usually mild and well-tolerated, not needing specific treatment.
Clinical effect 1: Serotonin syndrome
Clinical effect 2: Drowsiness/lethargy
Clinical effect 3: Agitation/Irritability/Restlessness
Clinical effect 4: Hallucinations
Clinical effect 5: Confusion
Clinical effect 6: Akathisia
Clinical effect 7: Tremor
Clinical effect 8: Clonus
Clinical effect 9: Muscular hypertonicity
Clinical effect 10: Hyperthermia
Clinical effect 11: Neuromuscular abnormalities
Clinical effect 12: Rigidity
Clinical effect 13: Autonomic instability
Clinical effect 14: Hypertension
Clinical effect 15: Tachycardia
Clinical effect 17: Seizure
Clinical effect 18: CNS depression
Poisoning cause: MILD TO MODERATE Trazodone TOXICITY
Toxic dose : 6 months - 79 years	>5 mg/kg OR >500 mg  • Child: Asymptomatic children with inadvertent ingestions Trazodone of up to 200 mg can be managed at home.
•Adult: An asymptomatic adult with an inadvertent ingestion of Trazodone of an extra dose can be managed at home.
• Ingestions up to 500 mg Trazodone are typically well-tolerated in toddlers.
•In adults, doses between 2 to 5 g Trazodone can lead to symptoms ranging from drowsiness to respiratory arrest.
•  Combined drug ingestions as low as 400 mg of Trazodone have resulted in fatalities.Per Olson guideline:toxic dose in adults:over 500-4000 mg. also based on another reference toxic dose is >5 mg/kg OR >500 mg
Management: Treatment is symptomatic and supportive
Clinical effect 1: Drowsiness/lethargy
Clinical effect 2: Ataxia
Clinical effect 3: Nausea
Clinical effect 4: Vomiting
Clinical effect 5: Tinnitus
Clinical effect 6: Myoclonus
Clinical effect 7: Peripheral edema
Poisoning cause: SEVERE Trazodone TOXICITY
Toxic dose : • Child: Asymptomatic children with inadvertent ingestions Trazodone of up to 200 mg can be managed at home.
•Adult: An asymptomatic adult with an inadvertent ingestion of Trazodone of an extra dose can be managed at home.
• Ingestions up to 500 mg Trazodone are typically well-tolerated in toddlers.
•In adults, doses between 2 to 5 g Trazodone can lead to symptoms ranging from drowsiness to respiratory arrest.
•  Combined drug ingestions as low as 400 mg of Trazodone have resulted in fatalities.Per Olson guideline:toxic dose in adults:over 500-4000 mg. also based on another reference toxic dose is >5 mg/kg OR >500 mg
Management: Treat hypotension with intravenous fluids, add vasopressors, if hypotension persists. Treat bradycardia associated with hypotension with atropine. Treat seizures with benzodiazepines initially
Clinical effect 1: Lethargy
Clinical effect 2: Seizure
Clinical effect 3: Coma
Clinical effect 4: Bradycardia
Clinical effect 5: Hypotension
Clinical effect 6: Priapism
Clinical effect 7: Nonspecific st-t wave changes
Clinical effect 8: QTc prolongation
Clinical effect 9: Ventricular premature depolarization
Clinical effect 10: Right bundle-branch block
Clinical effect 11: T-wave inversion
Clinical effect 12: Conduction disturbances/AV block
Clinical effect 13: Torsade de pointes
Clinical effect 14: Serotonin syndrome
Poisoning cause: MILD TO MODERATE Acebutolol TOXICITY
Toxic dose : Over 600 mg (adult), Over 12 mg/kg (child)
Management: 1.Cardiac Monitoring: Place patient on a cardiac monitor. 2.Fluids for Hypotension: Administer fluids for hypotension. 3.Atropine for Bradycardia: Use atropine for symptomatic bradycardia
Clinical effect 1: Bradycardia
Clinical effect 2: Hypotension
Poisoning cause: SEVERE Acebutolol TOXICITY
Toxic dose : Over 600 mg (adult), Over 12 mg/kg (child)
Management: 1.Airway Protection: Perform early orotracheal intubation if patient's mental status is altered. 2.Hypotension Management: •Intravenous Fluids: Give intravenous fluids (500 mL boluses up to 2L) for hypotension. •Atropine: Use atropine for symptomatic bradycardia. •Glucagon: Consider glucagon if inadequate response to intravenous fluids.
Clinical effect 1: Conduction disturbances/AV block
Clinical effect 3: Congestive heart failure
Clinical effect 4: Coma
Clinical effect 5: Cardiac arrest 
Clinical effect 6: Bradycardia
Clinical effect 7: Hypotension
Clinical effect 8: Bronchospasm
Clinical effect 9: Respiratory depression
Clinical effect 10: Seizure
Clinical effect 11: QRS widening
Clinical effect 12: Renal failure
Clinical effect 13: Pulmonary edema
Poisoning cause: MILD TO MODERATE Atenolol TOXICITY
Toxic dose : Over 200 mg (adult), Over 2 mg/kg (child)
Management: 1.Cardiac Monitoring: Place patient on a cardiac monitor. 2.Fluids for Hypotension: Administer fluids for hypotension. 3.Atropine for Bradycardia: Use atropine for symptomatic bradycardia.
Clinical effect 1: Bradycardia
Clinical effect 2: Hypotension
Poisoning cause: SEVERE Atenolol TOXICITY
Toxic dose : Over 200 mg (adult), Over 2 mg/kg (child)
Management: 1.Airway Protection: Perform early orotracheal intubation if patient's mental status is altered. 2.Hypotension Management: •Intravenous Fluids: Give intravenous fluids (500 mL boluses up to 2L) for hypotension. •Atropine: Use atropine for symptomatic bradycardia. •Glucagon: Consider glucagon if inadequate response to intravenous fluids.
Clinical effect 1: Conduction disturbances/AV block
Clinical effect 3: Congestive heart failure
Clinical effect 4: Coma
Clinical effect 5: Cardiac arrest 
Clinical effect 6: Bradycardia
Clinical effect 7: Hypotension
Clinical effect 8: Bronchospasm
Clinical effect 9: Respiratory depression
Clinical effect 10: Seizure
Clinical effect 11: QRS widening
Clinical effect 12: Renal failure
Clinical effect 13: Pulmonary edema
Poisoning cause: MILD TO MODERATE Carvedilol TOXICITY
Toxic dose : Over 50 mg (adult), Over 0.5 mg/kg (child)
Management: 1.Cardiac Monitoring: Place patient on a cardiac monitor. 2.Fluids for Hypotension: Administer fluids for hypotension. 3.Atropine for Bradycardia: Use atropine for symptomatic bradycardia.
Clinical effect 1: Bradycardia
Clinical effect 2: Hypotension
Poisoning cause: SEVERE Carvedilol TOXICITY
Toxic dose : Over 50 mg (adult), Over 0.5 mg/kg (child)
Management: 1.Airway Protection: Perform early orotracheal intubation if patient's mental status is altered. 2.Hypotension Management: •Intravenous Fluids: Give intravenous fluids (500 mL boluses up to 2L) for hypotension. •Atropine: Use atropine for symptomatic bradycardia. •Glucagon: Consider glucagon if inadequate response to intravenous fluids. 3.Catecholamines: Administer catecholamines (dopamine, norepinephrine, epinephrine) for patients unresponsive to fluids and glucagon; titrate down when high-dose insulin euglycemia therapy starts to work. 4.High-Dose Insulin Euglycemia: Consider for cases unresponsive to fluids and glucagon. 5.Intravenous Lipid Emulsion: Use in patients with refractory hypotension. 6.Non-Pharmacological Therapies: Consider cardiac pacing, intraaortic balloon pump, cardiopulmonary bypass, extracorporeal membrane oxygenation (ECMO). 7.Seizures Management: Aggressively treat seizures with benzodiazepines (e.g., lorazepam IV) and/or propofol. 8.Dysrhythmia Monitoring: Monitor for dysrhythmias and provide appropriate treatment.
Clinical effect 1: Conduction disturbances/AV block
Clinical effect 3: Congestive heart failure
Clinical effect 4: Coma
Clinical effect 5: Cardiac arrest 
Clinical effect 6: Bradycardia
Clinical effect 7: Hypotension
Clinical effect 8: Bronchospasm
Clinical effect 9: Respiratory depression
Clinical effect 10: Seizure
Clinical effect 11: QRS widening
Clinical effect 12: Renal failure
Clinical effect 13: Pulmonary edema
Poisoning cause: MILD TO MODERATE Labetalol TOXICITY
Toxic dose : Over 400 mg (adult), Over 20 mg/kg (child)
Management: 1.Cardiac Monitoring: Place patient on a cardiac monitor. 2.Fluids for Hypotension: Administer fluids for hypotension. 3.Atropine for Bradycardia: Use atropine for symptomatic bradycardia.
Clinical effect 1: Bradycardia
Clinical effect 2: Hypotension
Poisoning cause: SEVERE Labetalol  TOXICITY
Toxic dose : Over 400 mg (adult), Over 20 mg/kg (child)
Management: 1.Airway Protection: Perform early orotracheal intubation if patient's mental status is altered. 2.Hypotension Management: •Intravenous Fluids: Give intravenous fluids (500 mL boluses up to 2L) for hypotension. •Atropine: Use atropine for symptomatic bradycardia. •Glucagon: Consider glucagon if inadequate response to intravenous fluids. 3.Catecholamines: Administer catecholamines (dopamine, norepinephrine, epinephrine) for patients unresponsive to fluids and glucagon; titrate down when high-dose insulin euglycemia therapy starts to work. 4.High-Dose Insulin Euglycemia: Consider for cases unresponsive to fluids and glucagon. 5.Intravenous Lipid Emulsion: Use in patients with refractory hypotension. 6.Non-Pharmacological Therapies: Consider cardiac pacing, intraaortic balloon pump, cardiopulmonary bypass, extracorporeal membrane oxygenation (ECMO). 7.Seizures Management: Aggressively treat seizures with benzodiazepines (e.g., lorazepam IV) and/or propofol. 8.Dysrhythmia Monitoring: Monitor for dysrhythmias and provide appropriate treatment.
Clinical effect 1: Conduction disturbances/AV block
Clinical effect 3: Congestive heart failure
Clinical effect 4: Coma
Clinical effect 5: Cardiac arrest 
Clinical effect 6: Bradycardia
Clinical effect 7: Hypotension
Clinical effect 8: Bronchospasm
Clinical effect 9: Respiratory depression
Clinical effect 10: Seizure
Clinical effect 11: QRS widening
Clinical effect 12: Renal failure
Clinical effect 13: Pulmonary edema
Poisoning cause: MILD TO MODERATE Metoprolol TOXICITY
Toxic dose : Over 450 mg (adult and Immediate-Release), Over 400 mg (adult and Sustained-Release), Over 2.5 mg/kg (child and Immediate-Release), Over 5 mg/kg (child and Sustained-Release)
Management: 4.Cardiac Monitoring: Place patient on a cardiac monitor. 5.Fluids for Hypotension: Administer fluids for hypotension. 6.Atropine for Bradycardia: Use atropine for symptomatic bradycardia.
Clinical effect 1: Bradycardia
Clinical effect 2: Hypotension
Poisoning cause: SEVERE Metoprolol TOXICITY
Toxic dose : Over 450 mg (adult and Immediate-Release), Over 400 mg (adult and Sustained-Release), Over 2.5 mg/kg (child and Immediate-Release), Over 5 mg/kg (child and Sustained-Release)
Management: Airway Protection: Perform early orotracheal intubation if patient's mental status is altered. Hypotension Management: •Intravenous Fluids: Give intravenous fluids (500 mL boluses up to 2L) for hypotension. •Atropine: Use atropine for symptomatic bradycardia. •Glucagon: Consider glucagon if inadequate response to intravenous fluids. Catecholamines: Administer catecholamines (dopamine, norepinephrine, epinephrine) for patients unresponsive to fluids and glucagon; titrate down when high-dose insulin euglycemia therapy starts to work. High-Dose Insulin Euglycemia: Consider for cases unresponsive to fluids and glucagon. Intravenous Lipid Emulsion: Use in patients with refractory hypotension. Non-Pharmacological Therapies: Consider cardiac pacing, intraaortic balloon pump, cardiopulmonary bypass, extracorporeal membrane oxygenation (ECMO). Seizures Management: Aggressively treat seizures with benzodiazepines (e.g., lorazepam IV) and/or propofol. Dysrhythmia Monitoring: Monitor for dysrhythmias and provide appropriate treatment.
Clinical effect 1: Conduction disturbances/AV block
Clinical effect 3: Congestive heart failure
Clinical effect 4: Coma
Clinical effect 5: Cardiac arrest 
Clinical effect 6: Bradycardia
Clinical effect 7: Hypotension
Clinical effect 8: Bronchospasm
Clinical effect 9: Respiratory depression
Clinical effect 10: Seizure
Clinical effect 11: QRS widening
Clinical effect 12: Renal failure
Clinical effect 13: Pulmonary edema
Poisoning cause: MILD TO MODERATE Nadolol TOXICITY
Toxic dose : Over 320 mg (adult), Over 2.5 mg/kg (child)
Management: Cardiac Monitoring: Place patient on a cardiac monitor. Fluids for Hypotension: Administer fluids for hypotension. Atropine for Bradycardia: Use atropine for symptomatic bradycardia.
Clinical effect 1: Bradycardia
Clinical effect 2: Hypotension
Poisoning cause: SEVERE Nadolol TOXICITY
Toxic dose : Over 320 mg (adult), Over 2.5 mg/kg (child)
Management: Airway Protection: Perform early orotracheal intubation if patient's mental status is altered. Hypotension Management: •Intravenous Fluids: Give intravenous fluids (500 mL boluses up to 2L) for hypotension. •Atropine: Use atropine for symptomatic bradycardia. •Glucagon: Consider glucagon if inadequate response to intravenous fluids. Catecholamines: Administer catecholamines (dopamine, norepinephrine, epinephrine) for patients unresponsive to fluids and glucagon; titrate down when high-dose insulin euglycemia therapy starts to work. High-Dose Insulin Euglycemia: Consider for cases unresponsive to fluids and glucagon. Intravenous Lipid Emulsion: Use in patients with refractory hypotension. Non-Pharmacological Therapies: Consider cardiac pacing, intraaortic balloon pump, cardiopulmonary bypass, extracorporeal membrane oxygenation (ECMO). Seizures Management: Aggressively treat seizures with benzodiazepines (e.g., lorazepam IV) and/or propofol. Dysrhythmia Monitoring: Monitor for dysrhythmias and provide appropriate treatment.
Clinical effect 1: Conduction disturbances/AV block
Clinical effect 3: Congestive heart failure
Clinical effect 4: Coma
Clinical effect 5: Cardiac arrest 
Clinical effect 6: Bradycardia
Clinical effect 7: Hypotension
Clinical effect 8: Bronchospasm
Clinical effect 9: Respiratory depression
Clinical effect 10: Seizure
Clinical effect 11: QRS widening
Clinical effect 12: Renal failure
Clinical effect 13: Pulmonary edema
Poisoning cause: MILD TO MODERATE Propranolol TOXICITY
Toxic dose : Over 240 mg (adult), Over 4 mg/kg (child and Immediate-Release), Over 5 mg/kg (child and Sustained-Release)
Management: Cardiac Monitoring: Place patient on a cardiac monitor. Fluids for Hypotension: Administer fluids for hypotension. Atropine for Bradycardia: Use atropine for symptomatic bradycardia.
Clinical effect 1: Bradycardia
Clinical effect 2: Hypotension
Poisoning cause: SEVERE Propranolol TOXICITY
Toxic dose : Over 240 mg (adult), Over 4 mg/kg (child and Immediate-Release), Over 5 mg/kg (child and Sustained-Release)
Management:  intubation if patient's mental status is altered.
Clinical effect 1: Conduction disturbances/AV block
Clinical effect 3: Congestive heart failure
Clinical effect 4: Coma
Clinical effect 5: Cardiac arrest 
Clinical effect 6: Bradycardia
Clinical effect 7: Hypotension
Clinical effect 8: Bronchospasm
Clinical effect 9: Respiratory depression
Clinical effect 10: Seizure
Clinical effect 11: QRS widening
Clinical effect 12: Renal failure
Clinical effect 13: Pulmonary edema
Poisoning cause: MILD TO MODERATE Timolol TOXICITY
Toxic dose : Over 30 mg (adult), Over 0 mg (child)
Management: Place patient on a cardiac monitor, give fluids for hypotension, and atropine for bradycardia.
Clinical effect 1: Bradycardia
Clinical effect 2: Hypotension