Calcium Channel Blocker Toxicity Questions & Answers

Updated: Mar 25, 2021
  • Author: B Zane Horowitz, MD, FACMT; Chief Editor: Michael A Miller, MD  more...
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Questions & Answers

Overview

What is the progression of calcium channel blocker (CCB) toxicity?

What are the signs and symptoms of calcium channel blocker (CCB) toxicity?

Which physical findings are characteristic of calcium channel blocker (CCB) toxicity?

Which abnormal blood test findings are characteristic of calcium channel blocker (CCB) toxicity?

Which ECG findings are characteristic of calcium channel blocker (CCB) toxicity?

Which lab tests are performed in the workup of calcium channel blocker (CCB) toxicity after a suicide attempt?

How are asymptomatic patients with significant exposure to calcium channel blockers (CCBs) treated?

When is consultation with a medical toxicologist indicated for the treatment of calcium channel blocker (CCB) toxicity?

Which medications are used in the treatment of calcium channel blocker (CCB) toxicity?

How is calcium administered in the treatment of calcium channel blocker (CCB) toxicity?

How is glucagon administered in the treatment of calcium channel blocker (CCB) toxicity?

How is high-dose insulin euglycemia (HIE) administered in the treatment of calcium channel blocker (CCB) toxicity?

What is calcium channel blocker (CCB) toxicity?

What is the pathophysiology of calcium channel blocker (CCB) toxicity?

What are the cardiovascular effects of calcium channel blocker (CCB) toxicity?

What are the physiologic responses to calcium channel blocker (CCB) overdose?

What causes calcium channel blocker (CCB) toxicity?

What are the subclasses of calcium channel blockers (CCBs)?

What are the pharmacokinetics of calcium channel blockers (CCBs)?

What is the pathogenesis of verapamil toxicity?

What is the pathogenesis of diltiazem toxicity?

What is the pathogenesis of nifedipine toxicity?

What is the pathogenesis of nicardipine and nimodipine toxicity?

What is the pathogenesis of amlodipine toxicity?

What is the pathogenesis of felodipine toxicity?

What is the pathogenesis of isradipine toxicity?

What is the pathogenesis of nisoldipine toxicity?

What is the pathogenesis of clevidipine toxicity?

What is the prevalence of calcium channel blocker (CCB) toxicity in the US?

Which patient groups have the highest prevalence of calcium channel blocker (CCB) toxicity?

What is the prognosis of calcium channel blocker (CCB) toxicity?

What are the possible complications of calcium channel blocker (CCB) toxicity?

What is included in patient education about calcium channel blocker (CCB) toxicity?

Presentation

When is hospitalization indicated for the management of calcium channel blocker (CCB) toxicity in children?

When is hospitalization indicated for the management of calcium channel blocker (CCB) toxicity in adults?

Which clinical history findings are characteristic of calcium channel blocker (CCB) toxicity?

What are the signs and symptoms of calcium channel blocker (CCB) overdose?

What is included in the physical exam to evaluate calcium channel blocker (CCB) toxicity?

DDX

Which conditions are included in the differential diagnoses of calcium channel blocker (CCB) toxicity?

Which conditions are included in the differential diagnoses of calcium channel blocker (CCB) toxicity?

What are the differential diagnoses for Calcium Channel Blocker Toxicity?

Workup

Which tests are included in the workup of calcium channel blocker (CCB) toxicity?

What is the role of glucose levels in the workup of calcium channel blocker (CCB) toxicity?

What is the role of ECG in the workup of calcium channel blocker (CCB) toxicity?

What is the role of imaging studies in the workup of calcium channel blocker (CCB) toxicity?

Treatment

How is calcium channel blocker (CCB) toxicity treated?

What is included in prehospital care for calcium channel blocker (CCB) toxicity?

How is calcium channel blocker (CCB) toxicity treated in the emergency department (ED)?

When is inpatient evaluation indicated in the treatment of calcium channel blocker (CCB) toxicity?

What is the role of GI decontamination in the treatment of calcium channel blocker (CCB) toxicity?

What is the role of activated charcoal in the treatment of calcium channel blocker (CCB) toxicity?

What is the role of gastric lavage in the treatment of calcium channel blocker (CCB) toxicity?

What is the role of whole-bowel irrigation in the treatment of calcium channel blocker (CCB) toxicity?

How is hypotension treated in calcium channel blocker (CCB) toxicity?

What is the role of calcium therapy in the treatment of calcium channel blocker (CCB) toxicity?

What is the role of glucagon therapy in the treatment of calcium channel blocker (CCB) toxicity?

What is the role of vasopressor therapy in the treatment of calcium channel blocker (CCB) toxicity?

What is the role of insulin therapy in the treatment of calcium channel blocker (CCB) toxicity?

When is insulin therapy indicated in the treatment of calcium channel blocker (CCB) toxicity?

What are the guidelines on high-dose insulin euglycemia (HIC) for the treatment of calcium channel blocker (CCB) toxicity?

What is the role of dextrose in the treatment of calcium channel blocker (CCB) toxicity?

What is the role of potassium in the treatment of calcium channel blocker (CCB) toxicity?

How is refractory calcium channel blocker (CCB) toxicity treated?

What is the role of methylene blue in the treatment of calcium channel blocker (CCB) toxicity?

What is the role of lipid emulsion therapy in the treatment of calcium channel blocker (CCB) toxicity?

How is lipid emulsion therapy administered in the treatment of calcium channel blocker (CCB) toxicity?

What is the role of 4-aminopyridine and 3.4 diaminopyridine in the treatment of calcium channel blocker (CCB) toxicity?

What is the role of levosimendan (Simdax) in the treatment of calcium channel blocker (CCB) toxicity?

Which medical procedures are indicated in the treatment of calcium channel blocker (CCB) toxicity?

Which dietary and activity modifications are used in the treatment of calcium channel blocker (CCB) toxicity?

Which specialist consultations are beneficial to patients with calcium channel blocker (CCB) toxicity?

When is patient transfer indicated for the treatment of calcium channel blocker (CCB) toxicity?

Medications

What is the role of medications in the treatment of calcium channel blocker (CCB) toxicity?

Which medications in the drug class Laxatives, Osmotic are used in the treatment of Calcium Channel Blocker Toxicity?

Which medications in the drug class Antidiabetics, Insulins are used in the treatment of Calcium Channel Blocker Toxicity?

Which medications in the drug class Anticholinergic Agents are used in the treatment of Calcium Channel Blocker Toxicity?

Which medications in the drug class Glucose-Elevating Agents are used in the treatment of Calcium Channel Blocker Toxicity?

Which medications in the drug class Inotropic Agents are used in the treatment of Calcium Channel Blocker Toxicity?

Which medications in the drug class Posterior Pituitary Hormones are used in the treatment of Calcium Channel Blocker Toxicity?

Which medications in the drug class Alpha Adrenergic Agonists are used in the treatment of Calcium Channel Blocker Toxicity?

Which medications in the drug class Alpha/Beta Adrenergic Agonists are used in the treatment of Calcium Channel Blocker Toxicity?

Which medications in the drug class Calcium Salts are used in the treatment of Calcium Channel Blocker Toxicity?

Which medications in the drug class Antidotes, Other are used in the treatment of Calcium Channel Blocker Toxicity?