Utilization of a glucagon infusion in the management of a massive nifedipine overdose

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

“…Time-to-peak effects varied and were difficult to discern and summarize in a useful format based solely on the level 4 reports available. However, it was noted that in several instances of overdose with modified-release (SR) products, patients deteriorated clinically many hours into the course of their poisoning (46,48,63,64,101,103,105,107,109). In many such cases, there were mild clinical or electrocardiographic signs of toxicity early on, but in others these clues were either not reported or not clearly evident.…”

Could Glucagon be a Therapeutic Option in the Management of Acute Aluminium Phosphide Toxicity?

“…In the six studies of animal models of calcium channel blocker overdose included, glucagon appeared to have increased the heart rate and cardiac output and reverse second and third degree AV blocks, all at least transiently [8,11]. Glucagon may decrease vasopressor requirements in calcium channel blocker toxicity [12]. Its infusion significantly increases mean blood pressure and heart rate in severe amitriptyline toxicity [13].…”

Calcium Channel Blocker Toxicity

“…24 It is unclear whether glucagon use would confer any additional benefit over traditional vasopressors in pure CCB toxicity. 25 In addition, glucagon is known to cause pheochromocytoma catecholamine release and is contraindicated in these patients. 24 A suggested loading dose is 50 Kg/kg intravenously over 1 to 2 minutes.…”