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Review
. 2022 Jun;61(Suppl 1):73-77.
doi: 10.20471/acc.2022.61.s1.12.

HIGH-DOSE INSULIN EUGLYCEMIC THERAPY

Jasmin Hamzić  1 , Dora Raos  1 , Bojana Radulović  1
Affiliations
Review

HIGH-DOSE INSULIN EUGLYCEMIC THERAPY

Jasmin Hamzić et al. Acta Clin Croat. 2022 Jun.

Abstract

Calcium channel blockers and beta-blockers toxicity/poisoning are one of the most common causes of poisoning. More importantly, they are among the deadliest types of poisoning caused by cardiac drugs that emergency physicians can encounter. Common toxidrome caused by these medications includes the following symptoms: hypotension, bradycardia, hypoglycemia/hyperglycemia, hypothermia, arrhythmia, and seizures. Treatment is usually complex, It consists of administration of various medications, such as crystalloids, intravenous calcium, glucagon, vasopressors/inotropes, and especially high-dose insulin euglycemic therapy. In this paper, we will review the mechanism for this type of treatment, propose a potential protocol for its application and address possible adverse effects. High-dose insulin euglycemic therapy should be an integral part of the treatment protocol for calcium channel blockers and beta-blockers toxicity.

Keywords: beta-blockers; calcium channel blockers; high-dose insulin euglycemic therapy; toxicity.

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References

    1. Gummin DD, Mowry JB, Spyker DA, Brooks DE, Fraser MO, Banner W. 2016 Annual Report of the American Association of Poison Control Centers’ s Poison Data System (NPDS): 34th Annual Report. Clin Toxicol (Phila). 2017. December;55(10):1072–252. Epub 2017 Nov 29. [Erratum in: Clin Toxicol ] [Phila] [. 2017 Dec;55] [10]:125610.1080/15563650.2017.1388087 - DOI - PubMed
    1. EMCrit A. Farkas J. Calcium Channel Blocker (CCB) & Beta-Blocker (BBl) overdose [Internet]. EMCrit Project. 2022 [cited 13 February 2022]. Available from: https://emcrit.org/ibcc/ccb/
    1. Graudins A, Lee HM, Druda D. Calcium channel antagonist and beta-blocker overdose: antidotes and adjunct therapies. Br J Clin Pharmacol. 2016. March;81(3):453–61. 10.1111/bcp.12763 - DOI - PMC - PubMed
    1. St-Onge M, Anseeuw K, Cantrell FL, Gilchrist IC, Hantson P, Bailey B, et al. Experts Consensus Recommendations for the Management of Calcium Channel Blocker Poisoning in Adults. Crit Care Med. 2017. March;45(3):e306–15. 10.1097/CCM.0000000000002087 - DOI - PMC - PubMed
    1. Kline JA, Leonova E, Raymond RM. Beneficial myocardial metabolic effects of insulin during verapamil toxicity in the anesthetized canine. Crit Care Med. 1995. July;23(7):1251–63. 10.1097/00003246-199507000-00016 - DOI - PubMed

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