Abstract
In Reply.— The authors infer that 50 mg of phenol will cause toxic manifestations, when in fact, this amount has rarely if ever caused side effects when glucagon has been used as an antidote for β-blocker overdose.1Acute oral injestions of 1 to 2 g or more of phenol usually result in the aforementioned toxic side effects.2-4Since the majority of patients with propranolol overdose have required fewer than 24 hours of glucagon infusion (5 mg/hr or less),1the recommended use of dextrose or saline as a diluent (shelf life cannot be guaranteed by the manufacturer) may not be appropriate. Overdose with β-blockers with a longer half-life or with sustainedrelease preparations may require longer glucagon infusions. In this setting, the use of a nonphenolcontaining diluent may be indicated.
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