Use of amrinone and glucagon in a case of calcium channel blocker overdose

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

“…Other treatments that were mentioned in the articles as being potentially beneficial but that would not likely be available to, or practicable for, U.S. out-ofhospital personnel are not listed in the table. These include dexamethasone (81), methylscopolamine (91), metaproterenol (66,139), 4-aminopyridine (134), amrinone (96,138), angiotensin II (25), theophylline (139), enoxamine (73), and vasopressin (112). General supportive care measures (e.g., airway management measures, fluids, anticonvulsants, bicarbonate) might have been beneficial in some cases but were difficult to evaluate and are not specifically addressed in the table or this summary.…”

Therapeutic Approach to the Critically Poisoned Patient

“…Inamrinone, a phosphodiesterase type III inhibitor formerly known as amrinone, prevents the breakdown of intracellular cAMP. Inamrinone administration has been reported to reverse hypotension in overdoses of calcium channel antagonists [107], chloroquine [108], and propranolol [109]. It has also reversed hypotension in calcium channel antagonist overdoses in animals [110,111].…”

Toxicologic issues during cardiopulmonary resuscitation

“…Successful resuscitation with Terlipressin (tri-glycycl-lysine vasopressin) -a longer acting analogue of vasopressin with more specificity for the V1a receptors -has been described in case reports outside of the United States [50,51 ,52]. Use of phosphodiesterase III inhibitors has been described in case reports [53,54,55 ]. Phosphodiesterase inhibitors cause an increase in cyclic adenosine monophosphate (cAMP), which results in positive inotropy and improved myocardial contractility.…”