Verapamil, a potent calcium antagonist, possesses varied systemic effects, including smooth muscle relaxation leading to both peripheral and coronary artery vasodilation, slowed atrioventricular nodal conduction and decreased insulin release from the pancreatic B cells. Reports concerning the effects of acute intoxication with verapamil are scarce. A case is presented of a 22 year old woman who developed profound hyperglycemia and metabolic acidosis after the inadvertent overdose of thirty 80 mg tablets (2,400 mg) of verapamil. This case illustrates the need for physicians to be aware of verapamil's inhibitory effects on insulin release and to exercise special care when prescribing verapamil in patients with preexisting diabetes mellitus.

As the divorce rate climbs, more and more children are affected by divorce. For some of these children, the personal losses they suffer are too great to overcome. Young children are particularly vulnerable to feelings of guilt, shame, inferiority, and distrust, which may lead to more serious problems later in life. Dr Price and colleagues offer suggestions to primary care physicians on counseling children of divorce and their parents, with emphasis on a holistic, empathic approach to therapy.