Circulation

For hypotension due to quetiapine poisoning, first-line treatment is intravenous fluid resuscitation. If hypotension persists, start inotropic support. Noradrenaline (norepinephrine) is the preferred first-line inotrope (see Noradrenaline (norepinephrine) intravenous infusion instructions for advice on preparation and administration of noradrenaline). Adrenaline should usually be avoided as it can worsen hypotension caused by alpha-adrenoceptor blockade (due to beta2 adrenoceptor–mediated vasodilation). Adrenaline can be used if indicated for bradycardia or cardiogenic shock.