Back to Basics: Beta Blocker & Calcium Channel Blocker Overdoses
Beta-blocker (BB) and Calcium Channel Blocker (CCB) Overdoses
Author: Valeria Chew
These medications are prescribed for:
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BBs |
CCBs |
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hypertension |
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dysrhythmias |
|
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heart failure |
angina |
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cardiomyopathies |
migraine prophylaxis |
|
glaucoma |
esophageal spasm |
|
social anxiety |
arterial vasospasm |
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thyroid disorders |
pulmonary hypertension |
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… to name a few |
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How it works:
|
BBs |
CCBs |
|
work at beta-adrenergic receptors to decrease cAMP release and decrease contractility by decreasing calcium release
can affect metabolism (glycogenolysis and gluconeogenesis) |
bind and prevent calcium channels from releasing calcium, decreasing contractility |
How an OD presents:
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BBs |
CCBs |
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hypotension |
|
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bradycardia |
|
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heart blocks |
|
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dysrhythmias |
|
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decreased cardiac contractility |
|
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seizures |
|
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lethargy |
pulmonary edema |
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coma |
delirium |
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apnea / respiratory arrest |
stroke |
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bronchospasm |
bowel necrosis/ischemia |
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hypoglycemia |
hyperglycemia |
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hyperkalemia |
nausea |
|
coma |
vomiting |
Be wary of calcium channel blockers with kids, fatality can occur with just one tablet!
Tune in next week for treatment!!
Resources
Kerns W: Management of beta-adrenergic blocker and calcium channel antagonist toxicity. Emerg Med Clin North Am 25: 309, 2007.
Riddle MK, Tomaszewski C. Beta-Blockers. In: Tintinalli JE, Ma O, Yealy DM, Meckler GD, Stapczynski J, Cline DM, Thomas SH. eds. Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 9e.
Litovitz TL, Schmitz BF, Holm KC: 1988 annual report of the American Association of Poison Control Centers National Data Collection System. Am J Emerg Med 7: 495, 1989.
Masom C.P., & Tomaszewski C (2020). Calcium channel blockers. In: Tintinalli J.E., & Ma O, & Yealy D.M., & Meckler G.D., & Stapczynski J, & Cline D.M., & Thomas S.H.(Eds.), Tintinalli's Emergency Medicine: A Comprehensive Study Guide, 9e.