A one-year evaluation of calcium channel blocker overdoses: toxicity and treatment.
OBJECTIVE
To examine the cardiovascular toxicity of calcium channel blockers and the efficacy of various treatments.


METHODS
Case series collected prospectively over one year.


METHODS
Three regional poison control centers.


METHODS
One hundred thirty-nine hospitalized patients who had ingested a calcium channel blocker.


METHODS
Calcium, dopamine, atropine, isoproterenol, glucagon, and pacemakers.


RESULTS
Hypotension, sinus node suppression, and dysrhythmias often occur with calcium channel blocker overdoses, but atrioventricular nodal block occurs more often with verapamil (chi 2 test, P < .025). Calcium was administered to 23 patients and was efficacious in reversing depression of cardiac conduction and increasing blood pressure. Dopamine was administered to ten patients and was efficacious in increasing blood pressure. Atropine was administered to eight patients, but only two had a positive response.


CONCLUSIONS
Atrioventricular nodal depression is more common with verapamil overdoses. Calcium and dopamine are useful in treating toxicity from calcium channel blocker overdose, whereas atropine is sometimes useful.
Ramoska
E A
EA
Division of Emergency Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
Spiller
H A
HA
Winter
M
M
Borys
D
D
D000293:Adolescent; D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000139:chemically induced*; D001285:Atropine / Q000627:therapeutic use; D002118:Calcium / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000506:poisoning*; D002648:Child; D002675:Child, Preschool; D004110:Diltiazem / Q000506:poisoning; D004298:Dopamine / Q000627:therapeutic use*; D062787:Drug Overdose / Q000188:drug therapy; D005069:Evaluation Studies as Topic; D005260:Female; D006327:Heart Block / Q000139:chemically induced; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D007223:Infant; D008297:Male; D008875:Middle Aged; D009543:Nifedipine / Q000506:poisoning; D011446:Prospective Studies; D014700:Verapamil / Q000506:poisoning
D002121:Calcium Channel Blockers; D001285:Atropine; D014700:Verapamil; D004110:Diltiazem; D009543:Nifedipine; D002118:Calcium; D004298:Dopamine