Calcium channel blocker toxicity is the taking of too much of the medications known as calcium channel blockers (CCBs), either by accident or on purpose.[3] This often causes a slow heart rate and low blood pressure.[1] This can progress to the heart stopping altogether.[2] Some CCBs can also cause a fast heart rate as a result of the low blood pressure.[4] Other symptoms may include nausea, vomiting, sleepiness, and shortness of breath.[2] Symptoms usually occur in the first six hours but with some forms of the medication may not start until 24 after hours.[2]
There are a number of treatments that may be useful.[1] These include efforts to reduce absorption of the drug including: activated charcoal taken by mouth if given shortly after the ingestion or whole bowel irrigation if an extended release formula was taken.[1] Efforts to bring about vomiting are not recommended.[1] Medications to treat the toxic effects include: intravenous fluids, calcium gluconate, glucagon, high dose insulin, vasopressors and lipid emulsion.[1][2] Extracorporeal membrane oxygenation may also be an option.[1]
More than ten thousand cases of calcium channel blocker toxicity were reported in the United States in 2010.[2] Along with beta blockers and digoxin calcium channel blockers have one of the highest rates of death in overdose.[2] These medications first became available in the 1970s and 1980s.[2] They are one of the few types of medication in which one pill can result in the death of a child.[2]
^ abcdefghiPalatnick, Wesley (Feb 2014). "Emergency Department Management of Calcium-Channel Blocker, Beta Blocker, and Digoxin Toxicity". Emergency Medicine Practice. 16 (2): 1–19, quiz 19-20. PMID 24883458. Archived from the original on 2014-05-14.
^ abcdefghijklmnMarx, John A. Marx (2014). "Cardiovascular Drugs". Rosen's emergency medicine: concepts and clinical practice (8th ed.). Philadelphia, PA: Elsevier/Saunders. pp. Chapter 152. ISBN 978-1455706051.
^ ab"Calcium channel blocker overdose". ADAM. 2011-01-19. Archived from the original on 5 April 2014. Retrieved 9 May 2014.
^Wolfson, Allan B. (2010). Harwood-Nuss' clinical practice of emergency medicine (5th ed.). Philadelphia, PA: Lippincott Williams & Wilkins. p. 1454. ISBN 9780781789431. Archived from the original on 15 August 2016. Retrieved 28 July 2016.
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