How do you treat calcium channel blocker overdose?
How do you treat calcium channel blocker overdose?
Calcium channel blocker (CCB) overdose is often lethal. Conventional medical treatment includes IV calcium, high doses of catecholamines, insulin, and glucagon. A new inotropic drug, levosimendan, should be considered in severe CCB poisoning.
How do you reverse a calcium channel blocker?
Therefore, despite the notion that calcium and glucagon are “antidotes,” vasopressor therapy with norepinephrine is required in most cases with hypotension. Additionally, high-dose insulin has been established as an effective therapy for calcium channel blocker overdose with cardiogenic shock.
How is sodium channel blocker toxicity treated?
Sodium bicarbonate or lactate, increasing serum pH and extracellular concentration of the ion, displace the drug from its receptor sites and can be used for the treatment of cardiac toxicity in the setting of sodium-channel blocker poisoning.
How does glucagon treat calcium channel blocker overdose?
Glucagon Therapy Glucagon promotes calcium entry into cells via stimulation of a receptor that is considered to be separate from adrenergic receptors. Note that the actions of glucagon oppose those of insulin, yet both have beneficial effects in treating CCB toxicity.
What is glucagon The antidote for?
Glucagon is traditionally considered a first line antidote for beta-blocker overdose. Glucagon has also been used in the setting of calcium channel blocker toxicity.
What happens if you overdose on calcium channel blockers?
Overdoses of immediate-release CCBs are characterized by rapid progression to hypotension, bradydysrhythmia, and cardiac arrest. Overdoses of extended-release formulations can result in delayed onset of dysrhythmias, shock, sudden cardiac collapse, and bowel ischemia.
What are the symptoms of diltiazem overdose?
The diagnosis of diltiazem overdose is based on clinical features affecting the central nervous system (for example, confusion, lethargy, coma, respiratory arrest), gastrointestinal system (nausea, vomiting), cardiovascular system (hypotension, bradycardias, and a variety of differing degrees of heart block), and …
Are calcium channel blockers reversible?
Hepatic injury from calcium channel blockers is usually mild and reversible, but rare symptomatic and severe instances have been reported. Agents most clearly linked to liver injury are verapamil, diltiazem, amlodipine and nifedipine, probably because these agents have been most widely used.
What is the best course of action for sodium channel blocker toxicity with bradycardia?
Norepinephrine may be a good choice if the heart rate is normal or mildly elevated. Epinephrine may be a favorable choice for patients with bradycardia. Vasopressin may be useful in refractory cases (since vasopressin bypasses the alpha-adrenergic receptor entirely).