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wikitox:management_of_serious_calcium_channel_blocker

Management of Serious Calcium Channel Blocker Overdose in Adults

Normal saline bolus (10–20 mL/kg)
Correct pH
10% calcium chloride, 5–10 mL, or 10% calcium gluconate, 10–20 mL, over 5 minutes

  • Repeat every 3–5 minutes, up to three to five doses
  • If response, institute calcium infusion (10% calcium chloride, 1–10 mL/hour)
  • Monitor serum calcium after 30 mL of calcium chloride or equivalent

Atropine, isoprenaline (isoproterenol) and/or pacing may be tried if associated symptomatic bradycardia
Dopamine infusion if persistent hypotension

Begin insulin euglycaemia therapy in any patient whose resuscitation requires more than just IV fluids as there is normally a delay in effect

Insulin bolus, 1 unit/kg with glucose, 50% dextrose, 25 ml i.v.
followed by
Insulin infusion, 0.5 units/kg/hour with 50% dextrose infusion, 0.5 g/hour, adjusted according to hourly glucose checks
Monitor potassium

As a last resort, extracorporeal blood pressure support (e.g. cardiopulmonary bypass) may be considered

/home/wikitoxo/public_html/data/pages/wikitox/management_of_serious_calcium_channel_blocker.txt · Last modified: 2018/09/01 09:01 (external edit)