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High-dose insulin euglycaemic therapy for a severe calcium channel blocker overdose
Massimo Catarinella1, Henrik Endeman2
1Cardiology, OLVG, Amsterdam, Netherlands.
BMJ Case Reports
|March 19, 2026
Summary
Severe calcium channel blocker poisoning can be fatal. High-dose insulin euglycaemic therapy (HIET) is a potentially effective treatment for these overdoses, as demonstrated in this case report.
Area of Science:
- Toxicology
- Cardiology
- Pharmacology
Background:
- Calcium channel blockers (CCBs) are frequently implicated in poisoning cases.
- CCB overdose is associated with significant patient mortality.
- Current treatment strategies for CCB overdose are complex and not well-established.
Purpose of the Study:
- To review a case of severe calcium channel blocker overdose.
- To evaluate the efficacy of high-dose insulin euglycaemic therapy (HIET) in treating CCB poisoning.
Main Methods:
- A case report detailing the management of a patient with severe CCB overdose.
- Administration of high-dose insulin euglycaemic therapy (HIET).
Main Results:
- The patient with severe CCB overdose was successfully treated with HIET.
- HIET demonstrated effectiveness in managing this complex poisoning case.
Conclusions:
- High-dose insulin euglycaemic therapy (HIET) is a promising treatment for severe calcium channel blocker poisoning.
- Further research into HIET for CCB overdose is warranted.
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