title: Management of a mixed overdose of calcium channel blockers, β-blockers and statins.
abstract: We describe a case of extreme mixed overdose of calcium channel blockers, β-blockers and statins. The patient was successfully treated with aggressive resuscitation including cardiac pacing and multiorgan support, glucagon and high-dose insulin for toxicity related to calcium channel blockade and β-blockade, and ubiquinone for treating severe presumed statin-induced rhabdomyolysis and muscle weakness.
authors.affiliation: Department of Critical Care, University College London Hospital Foundation Trust, London, UK.
authors.forename: Reena
authors.initials: R
authors.lastname: Thakrar
authors.affiliation: Pharmacy Department, University College London Hospital Foundation Trust, London, UK.
authors.forename: Rob
authors.initials: R
authors.lastname: Shulman
authors.affiliation: Department of Critical Care, University College London Hospital Foundation Trust, London, UK Bloomsbury Institute of Intensive Care Medicine, University College London, London, UK.
authors.forename: Geoff
authors.initials: G
authors.lastname: Bellingan
authors.affiliation: Bloomsbury Institute of Intensive Care Medicine, University College London, London, UK.
authors.forename: Mervyn
authors.initials: M
authors.lastname: Singer
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000506:poisoning*; D000328:Adult; D017298:Bisoprolol / Q000506:poisoning; D001919:Bradycardia / Q000139:chemically induced* / Q000628:therapy; D002121:Calcium Channel Blockers / Q000506:poisoning*; D002304:Cardiac Pacing, Artificial / Q000379:methods; D004110:Diltiazem / Q000506:poisoning; D062787:Drug Overdose / Q000628:therapy; D005440:Fluid Therapy; D005934:Glucagon / Q000627:therapeutic use; D006327:Heart Block / Q000139:chemically induced* / Q000628:therapy; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000506:poisoning*; D007004:Hypoglycemic Agents / Q000627:therapeutic use; D007022:Hypotension / Q000139:chemically induced* / Q000628:therapy; D007035:Hypothermia / Q000139:chemically induced* / Q000628:therapy; D007328:Insulin / Q000627:therapeutic use; D008297:Male; D019821:Simvastatin / Q000506:poisoning; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
chemical_list: D000319:Adrenergic beta-Antagonists; D002121:Calcium Channel Blockers; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007004:Hypoglycemic Agents; D007328:Insulin; D014662:Vasoconstrictor Agents; D005934:Glucagon; D019821:Simvastatin; D004110:Diltiazem; D017298:Bisoprolol