Pearls and Pitfalls for the Emergency Clinician: Beta Blocker and Calcium Channel Blocker Toxicity - PubMed
3 hours ago
- #Toxicology
- #Calcium channel blocker
- #Beta blocker
- Beta blocker or calcium channel blocker toxicity is a serious condition with high morbidity and mortality.
- Patients commonly present with hypotension and bradycardia, except for dihydropyridines like amlodipine, which may initially show hypotension and tachycardia.
- Propranolol can cause altered mentation, seizures, and ventricular dysrhythmias due to sodium channel blocking.
- Sotalol can lead to QT prolongation alongside hypotension and bradycardia.
- Laboratory tests evaluate end organ perfusion and possible concomitant ingestions but do not confirm toxicity.
- Initial treatment includes fluids, atropine, calcium, and GI decontamination with activated charcoal.
- Severe cases may require vasopressors, high-dose insulin, intralipid, or extracorporeal membrane oxygenation.
- Patients should be admitted to the ICU for close hemodynamic monitoring.