Glucagon in β‐Blocker and Calcium Channel Blocker Overdoses: A Systematic Review

Abstract

The evidence supporting the use of glucagon in the management of patients with beta-blocker and calcium channel blocker overdoses is limited to animal studies.

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

“…Other measures, particularly supportive measures, could either have been ongoing or were not specifically listed by the authors. In reviewing the evidence, it became clear that no intervention was reliably effective alone, although insulin/ dextrose shows promise (145) and glucagon animal data are encouraging (146). In the majority of cases, combinations of agents were necessary to provide hemodynamic support.…”

Treatment of poisoning caused by β-adrenergic and calcium-channel blockers

“…Animal studies comparing these agents demonstrated that glucagon was superior to isoproterenol and amrinone. 19,20 Although glucagon appears to consistently increase the heart rate, it does not consistently improve survival, particularly against propranolol intoxication.…”

“…22 A large number of case reports cite success with glucagon when used in conjunction with other agents, but fewer reports of success exist when it is used as the sole antidote. 3,20 However, several reports of glucagon failure also exist. 3 Variability in response to glucagon therapy is likely due to the differences in the type and β-blocker ingested, patient-specific factors, and the timing or content of therapy.…”

Kreislaufstillstand in besonderen Situationen

“…Therapieerfolge sind beim Einsatz von Glucagon (50-150 μg/kgKG, [357][358][359][360][361][362][363][364][365][366][367][368][369][370]), hochdosierter Insulin-und Glukosegabe [371][372][373], Lipidemulsionen [374][375][376][377], Phosphodiesterasehemmern [378,379], extrakorporaler Unterstützung und IAPB-Einsatz (intraaortale Ballonpumpe, [380][381][382] …”