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Updated: Aug 7, 2026

Improving IV Insulin Administration in a Community Hospital
Published on: June 11, 2012
Insulin-glucose as adjunctive therapy for severe calcium channel antagonist poisoning
T H Yuan1, W P Kerns, C A Tomaszewski
1Carolinas Medical Center, Charlotte, North Carolina 28232, USA.
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.
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