A one-year evaluation of calcium channel blocker overdoses: Toxicity and treatment

Calcium Channel Blocker Ingestion: An Evidence-Based Consensus Guideline for Out-of-Hospital Management

“…Several level 4 articles reported the use of ipecac syrup or other forms of induced emesis in patients with CCB overdose, but in most cases there were either no tablet fragments returned or the results of emesis induction were not reported (2,30,36,39,54,88,89,122). Only one level 4 report was found in which the authors reported the use of ipecac syrup to be successful in retrieving tablet fragments (95).…”

“…Because the toxic doses overlap with the upper therapeutic range for many of these drugs, poison control centers frequently recommend hospital evaluation after any CCB exposure. Moreover, because most CCBs are formulated as modified-release products that might have delayed onsets of symptoms, prolonged observation of asymptomatic patients is widely practiced (2). Finding a child with an open medicine container that might have contained just one tablet of a CCB is often followed by overnight hospital observation.…”

Effects of Isradipine, a Dihydropyridine-Class Calcium Channel Antagonist, on D-Methamphetamine-Induced Cognitive and Physiological Changes in Humans

“…Isradipine's anti-hypertensive (Brogden and Sorkin 1995) and negative inotropic (Leslie 1993) effects are due to a combination of calcium influx inhibition into arteriolar and myocardial smooth muscle (Apostolakos and Varon 1996) and a reduction of DA release. Indeed, DA infusions have been used successfully to treat the peripheral vasodilatation and hypotension associated with overdose or toxicity to calcium channel antagonists (Pearigen and Benowitz 1991;Ramoska et al 1993). While these data suggest that isradipine may be a useful therapeutic agent for the treatment of d-methamphetamine-induced hypertension, our literature search revealed no existing electronicallyindexed studies in animals or humans directly testing this interaction.…”

Efficacy of isoproterenol for treating amlodipine overdose resulting in bradycardia

“…A FlowTrack (Edwards Lifesciences, Irvine, CA, USA) was used to monitor the hemodynamic parameters, and the cardiac output index increased from 1.7 to 2.4 L/min/m 2 after starting the isoproterenol infusion. Isoproterenol is a non‐selective β‐adrenoreceptor to treat bradycardia associated with diltiazem and verapamil overdoses, which cause cardiotoxicity 12. Based on the current report,13 isoproterenol was used at 5–25 μg/min (maximal infusion rate is 60 μg/min).…”