Management of beta-adrenergic blocker and calcium channel antagonist toxicity.
State-of-the-art therapy for beta-adrenergic receptor blocker and calcium channel antagonist toxicity is reviewed in the light of new insights into drug-induced shock. A brief discussion of pathophysiology, including cardiac, hemodynamic, and metabolic effects of cardiac drug toxicity, provides a foundation for understanding the basis of therapy. The major focus of this review is a critical evaluation of antidotal use of calcium, glucagon, catecholamines, insulin-euglycemia, and other novel therapies based on investigational studies and cumulative clinical experience.
Kerns
William
W
Division of Toxicology, Department of Emergency Medicine, Carolinas Medical Center, Medical Education Building, Charlotte, NC 28203, USA. rkerns@carolinashealthcare.org
D000319:Adrenergic beta-Antagonists / Q000009:adverse effects*; D000931:Antidotes / Q000627:therapeutic use*; D002121:Calcium Channel Blockers / Q000009:adverse effects*; D002125:Calcium Gluconate / Q000097:blood / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000139:chemically induced / Q000188:drug therapy / Q000503:physiopathology; D002395:Catecholamines / Q000627:therapeutic use*; D062787:Drug Overdose; D006801:Humans; D006435:Renal Dialysis; D012151:Resuscitation / Q000379:methods; D017693:Sodium Bicarbonate / Q000627:therapeutic use*
D000319:Adrenergic beta-Antagonists; D000931:Antidotes; D002121:Calcium Channel Blockers; D002395:Catecholamines; D017693:Sodium Bicarbonate; D002125:Calcium Gluconate