Calcium channel blockers

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• 作者：Ian Whyte ; Nick Buckley ; Andrew Dawson
• 关键词：Antidotes ; calcium channel blockers ; cardiotoxicity ; poisoning
• 刊名：Medicine
• 出版年：2016
• 出版时间：March 2016
• 年：2016
• 卷：44
• 期：3
• 页码：148-150
• 全文大小：80 K

文摘

Overdose of calcium channel blockers is potentially lethal. Verapamil and diltiazem are much more dangerous than dihydropyridines. Hypotension with (verapamil and diltiazem) or without (dihydropyridines) heart block and bradycardia are the most important features. Routine management usually comprises intravenous fluids, activated charcoal, whole-bowel irrigation (for modified-release products) and prolonged electrocardiographic monitoring. Antidotes for cardiac effects include calcium, bicarbonate, high-dose insulin–euglycaemia and vasopressors with atropine and/or transvenous pacing in cases of symptomatic bradycardia.