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Successful Use of Calcium Chloride in Acute Calcium Channel Blocker Overdose With Shock: A Case Report

Shunsuke Nakamura1, Natsuyo Shinohara1

  • 1Department of Emergency Medicine, Okayama Rosai Hospital, Okayama, JPN.

Cureus
|April 10, 2025
PubMed

Insights

Severe calcium channel blocker overdose can cause life-threatening shock. Calcium chloride rapidly improved a patient

Area of Science:

  • Cardiology
  • Toxicology
  • Emergency Medicine

Background:

  • Calcium channel blockers (CCBs) are essential for managing hypertension and tachyarrhythmias.
  • Overdose of CCBs can precipitate severe toxicity, including hypotension and shock.
  • Standard antidotes may fail in critical CCB overdose scenarios.

Observation:

  • A 60-year-old female presented with hypotensive shock after an intentional amlodipine overdose.
  • Initial management with calcium gluconate, glucagon, and catecholamines failed to stabilize hemodynamics.
  • Intravenous calcium chloride administration was initiated.

Findings:

  • Calcium chloride administration led to rapid and significant hemodynamic improvement.
  • The patient ultimately recovered from the severe CCB toxicity.
  • This case suggests calcium chloride's efficacy in refractory CCB overdose.

Implications:

  • Calcium chloride may be a crucial first-line antidote for severe CCB overdose.
  • This finding could alter emergency treatment protocols for CCB toxicity.
  • Further research into calcium chloride's role in CCB poisoning is warranted.

Keywords:
calcium channel blockers (ccbs)calcium chlorideoverdoseshocktoxicity

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