Beta-blocker and calcium-channel blocker toxicity: current evidence on evaluation and management

Author:

Goldfine Charlotte E12ORCID,Troger Andrew23,Erickson Timothy B124,Chai Peter R12567ORCID

Affiliation:

1. Division of Medical Toxicology, Department of Emergency Medicine, Mass General Brigham Boston , 75 Francis St, Boson, MA 02115 , USA

2. Harvard Medical School , 25 Shattuck St, Boson, MA 02115 , USA

3. Division of Emergency Medicine, Boston Children’s Hospital , Boston, MA , USA

4. Department of Global Health and Population, Harvard Humanitarian Institute , Harvard T.H. Chan School of Public Health, Cambridge , USA

5. Department of Psychosocial Oncology and Palliative Care, Dana Farber Cancer Institute , Boston , USA

6. The Koch Institute for Integrated Cancer Research, Massachusetts Institute of Technology , Cambridge , USA

7. The Fenway Institute , Boston , USA

Abstract

Abstract Beta-blocker and calcium-channel blocker overdoses are associated with severe morbidity and mortality; therefore, it is important to recognize and appropriately treat individuals with toxicity. The most common clinical findings in toxicity are bradycardia and hypotension. In addition to supportive care and cardiac monitoring, specific treatment includes administration of calcium salts, vasopressors, and high-dose insulin euglycaemia treatment. Other advanced treatments (e.g. ECMO) may be indicated depending on the severity of toxicity and specific agents involved.

Publisher

Oxford University Press (OUP)

Subject

Cardiology and Cardiovascular Medicine,Critical Care and Intensive Care Medicine,General Medicine

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