title: A one-year evaluation of calcium channel blocker overdoses: toxicity and treatment.
abstract: 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.
authors.affiliation: Division of Emergency Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
authors.forename: E A
authors.initials: EA
authors.lastname: Ramoska
authors.forename: H A
authors.initials: HA
authors.lastname: Spiller
authors.forename: M
authors.initials: M
authors.lastname: Winter
authors.forename: D
authors.initials: D
authors.lastname: Borys
mesh_terms: 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
chemical_list: D002121:Calcium Channel Blockers; D001285:Atropine; D014700:Verapamil; D004110:Diltiazem; D009543:Nifedipine; D002118:Calcium; D004298:Dopamine