Verapamil and diltiazem commonly cause cardiovascular collapse following overdose and this may be delayed 4-16 hours after ingestion of the commonly ingested extended-release (XR) preparations. The other agents are not usually associated with severe toxicity.
References
- Buckley N, Dawson A, Whyte I. Calcium Channel Blockers. Medicine 2007; 35(11):134-139.
- DeWitt CR, Waksman JC. Pharmacology, pathophysiology and management of calcium channel blocker and b-blocker toxicity. Toxicological Reviews 2004; 23(4): 223-238.
- Mégarbane B, Karyo S, Baud FJ. The role of insulin and glucose (hyperinsulinaemia/euglycaemia) therapy in acute calcium channel antagonist and b-blocker toxicity. Toxicological Reviews 2004; 23(4): 215-222.
- Olsen KR, Erdman AR, Woolf AD et al. Calcium channel blocker ingestion: an evidence-based guideline for out-of-hospital management. Clinical Toxicology 2005; 43:797-822.
- Yuan TH, Kerns WP, Tomaszewski CA et al. Insulin-glucose as an adjunctive therapy for severe calcium channel antagonist poisoning. Clinical Toxicology 1999; 37(4): 463-474.
About Mike Cadogan
