Insulin-glucose as adjunctive therapy for severe calcium channel antagonist poisoning

Tony H. Yuan, William P. Kerns, Christian A. Tomaszewski, Marsha D. Ford, Jeffrey A. Kline

Research output: Contribution to journalArticle

159 Scopus citations

Abstract

Case Report: This case series documents the clinical courses of 4 patients after verapamil overdose and 1 patient after amlodipine-atenolol overdose. All subjects had hypodynamic circulatory shock (hypotension, bradycardia, and acidosis) that was not adequately responsive to conventional treatment. After initiation of insulin-dextrose infusion, the hemodynamic status of all 5 patients stabilized and all patients survived. Plasma drug concentrations are reported for all cases and verapamil levels were extremely high in 2 patients (3710 ng/mL and 3980 ng/mL). However, because patients were not treated according to a standard protocol, each patient received variable other supportive measures and inotropic agents, and the infusion rates of insulin were variable among patients. This report provides preliminary evidence toward a larger trial of insulin-dextrose to treat hypodynamic shock from calcium channel blocker overdose.

Original languageEnglish (US)
Pages (from-to)463-474
Number of pages12
JournalJournal of Toxicology - Clinical Toxicology
Volume37
Issue number4
DOIs
StatePublished - Aug 25 1999
Externally publishedYes

ASJC Scopus subject areas

  • Toxicology
  • Health, Toxicology and Mutagenesis

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