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Review
. 2022 Aug 30:15:1851-1862.
doi: 10.2147/JMDH.S374887. eCollection 2022.

Calcium Channel Blocker Toxicity: A Practical Approach

Omar A Alshaya  1   2   3 , Arwa Alhamed  3   4 , Sara Althewaibi  1 , Lolwa Fetyani  1 , Shaden Alshehri  1 , Fai Alnashmi  1 , Shmeylan Alharbi  1   2   3 , Mohammed Alrashed  1   2   3   5 , Saleh F Alqifari  6 , Abdulrahman I Alshaya  1   2   3
Affiliations
Review

Calcium Channel Blocker Toxicity: A Practical Approach

Omar A Alshaya et al. J Multidiscip Healthc. .

Abstract

Calcium channel blockers (CCBs) are widely prescribed medications for various clinical indications in adults and children. They are available in both immediate and long-acting formulations and are generally classified into dihydropyridines and nondihydropyridines, with nondihydropyridines having more cardioselectivity. CCB toxicity is common given the widespread use which leads to serious adverse clinical outcomes, especially in children. Severe CCB toxicities may present with life-threatening bradycardia, hypotension, hyperglycemia, and renal insufficiency. Dihydropyridine toxicity, however, may present with reflex tachycardia instead of bradycardia. Initial patient evaluation and assessment are crucial to identify the severity of CCB toxicity and design the best management strategy. There are different strategies to overcome CCB toxicity that requires precise dosing and close monitoring in various patient populations. These strategies may include large volumes of IV fluids, calcium salts, high insulin euglycemia therapy (HIET), and vasopressors. We hereby summarize the evidence behind the management of CCB toxicity and present a practical guide for clinicians to overcome this common drug toxicity.

Keywords: calcium channel blockers; drug overdose; emergency medicine; poisoning; toxicity.

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Conflict of interest statement

The authors report no conflicts of interest in this work and no financial supports.

Figures

Figure 1
Figure 1
Algorithmic structure for managing patients with calcium channel blocker toxicity.
See this image and copyright information in PMC

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