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β-Blocker and Calcium Channel Blocker Poisoning: High-Dose Insulin/Glucose Therapy.
1Dana Bartlett is an information specialist at the Connecticut Poison Control Center, Farmington, Connecticut. dana_bartlett@msn.com.
Critical Care Nurse
|April 3, 2016
Summary
High-dose insulin/glucose therapy effectively treats beta-blocker and calcium channel blocker overdoses when standard treatments fail. This life-saving intervention shows promise, though further research is needed to standardize its use.
Area of Science:
- Cardiology
- Toxicology
- Emergency Medicine
Background:
- Beta-blocker and calcium channel blocker overdoses cause severe toxicity.
- Conventional treatments for these overdoses are often ineffective.
- High-dose insulin/glucose therapy (HI/GT) is an alternative treatment.
Purpose of the Study:
- To review the effectiveness and safety of HI/GT for beta-blocker and calcium channel blocker overdoses.
- To highlight the current limitations and future directions for HI/GT.
Main Methods:
- Literature review of case reports and clinical experience with HI/GT.
- Analysis of documented successes and limitations of HI/GT.
- Discussion of the mechanisms of action and empirical guidelines for HI/GT.
Main Results:
- HI/GT has successfully reversed cardiotoxicity in overdose cases unresponsive to standard therapies.
- HI/GT appears to be relatively safe.
- Clinical experience is largely based on case reports, and mechanisms are not fully understood.
Conclusions:
- HI/GT is an effective and recommended treatment for severe beta-blocker and calcium channel blocker overdoses.
- Standardized guidelines for HI/GT are needed.
- Critical care nurses should be familiar with HI/GT protocols.
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