Pharmacotherapy Management of Calcium Channel Blocker Toxicity in the Emergency Department
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Updated: Oct 31, 2026

High-Throughput Optical Controlling and Recording Calcium Signal in iPSC-Derived Cardiomyocytes for Toxicity Testing and Phenotypic Drug Screening
Published on: March 31, 2022
1Author Affiliations: Cape Fear Valley Health, North Carolina (Knoche); and Department of Biomedical Sciences, School of Medicine Greenville, Department of Clinical Pharmacy and Outcomes Sciences, College of Pharmacy, University of South Carolina, Columbia, South Carolina (Weant).
Abstract:
Calcium channel blocker (CCB) overdose is a life-threatening toxicologic emergency characterized by profound cardiovascular instability. Emergency medicine personnel play a critical role in the early recognition, hemodynamic stabilization, and ongoing monitoring of these patients. This review provides a clinically focused discussion of the pathophysiology, clinical presentation, and emergency department management of CCB toxicity, with particular emphasis on intravenous fluids, atropine, calcium salts, vasopressors, hyperinsulinemic-euglycemic therapy, intravenous lipid emulsion, methylene blue, and extracorporeal membrane oxygenation. This review highlights the priorities in the monitoring and titration of therapies, underscoring the importance of a structured, multimodal approach to treatment. Early recognition and timely escalation of care are essential to improving outcomes in this high-risk population.
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