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Calcium channel blocker poisoning involves complex physiological changes and significant case-to-case variability; it is best treated by a multidisciplinary team with appropriate knowledge and experience in cardiovascular critical care support and in poisoning treatment.
These tips are provided as general information, but each poisoned patient warrants an individualized treatment plan and careful risk/benefit consideration of all treatment interventions.
Calcium channel blocking drugs may cause diminished vital organ perfusion through cardiogenic shock via a weakened heart pump and/or through distributive shock via peripheral vasodilation. Echocardiography and invasive cardiovascular monitoring may assist in patient care in some cases.
Treatment of calcium channel blocker-mediated shock should be targeted toward the underlying physiological changes.
Goal = to improve cardiac output to maintain sufficient perfusion of vital organs.
Goal = to effect peripheral vasoconstriction to maintain cerebral and coronary perfusion.
* Combined cardiac pump failure and vasoplegia are most typical of calcium channel blocker toxicity and multiple therapeutic pathways may need to be considered concurrently; again, the choice of therapies is best based upon the underlying physiology of shock.
**See The Poison Control Center’s Tip Sheets for high-dose insulin therapy and lipid emulsion therapy. The specialists and consulting toxicologists at The Poison Control Center may be able to provide more nuanced information to assist clinicians trying to make patient care decisions.
Released: July 1, 2014
Updated: Nov. 1, 2015, July 1, 2016
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