Apr 30, 2018
Author: Jared Scott, M.D.
- Cardiac myocytes and vascular smooth muscle are
dependent on an intracellular calcium influx for contraction.
Pancreatic beta cells rely on calcium to release
- Calcium channel blockers will decrease cardiac contractility
and heart rate, but will also cause vascular smooth muscle
relaxation with a subsequent decrease in systemic vascular
- Resultant cardiac depression and hypotension.
- Pancreatic beta cells also use calcium to release insulin, so
calcium channel blockade can cause hyperglycemia.
- Treatment for calcium channel toxicity include: fluid
resuscitation, calcium gluconate, vasopressors, and high dose
- Dosing for insulin therapy is usually 1-5 Units/kg/hr. Make
sure to add dextrose!
Boyer EW, Shannon M. (2001).Treatment of
calcium-channel-blocker intoxication with insulin
infusion. New England Journal of
Proano L, Chiang WK, Wang RY. (1995).Calcium channel
blocker overdose. American Journal of
Emergency Medicine. 13:444.
St-Onge M, Dubé PA, Gosselin S, et al. (2014). Treatment
for calcium channel blocker poisoning: a systematic