In Practice

Emergency management of calcium channel blocker overdose

V S Stephen, N A Pluymers, S J Gauton


Calcium channel blockers (CCBs) are commonly used in South Africa (SA) in the management of hypertension and other cardiovascular disease. Their ubiquitous availability makes them a common agent in drug overdose (OD), whether through accidental ingestion or deliberate self-harm. It is essential that medical practitioners know how to recognise and manage CCB OD, as severe CCB OD is often fatal. As there is a lack of local literature in SA, we highlight the general principles of management of CCB OD, as well as complications and problems that may be encountered during treatment. This narrative review is based on existing clinical guidelines, retrospective studies and systematic reviews on the emergency management of CCB OD. High-dose insulin euglycaemic therapy has become the mainstay of treatment in severe CCB OD. The rationale, the recommended protocol for its use and its adverse effects are described.

Authors' affiliations

V S Stephen, Emergency Department, Thelle Mogoerane Regional Hospital, Vosloorus, South Africa; Division of Emergency Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

N A Pluymers, Emergency Department, Thelle Mogoerane Regional Hospital, Vosloorus, South Africa

S J Gauton, Department of Internal Medicine, Thelle Mogoerane Regional Hospital, Vosloorus, South Africa

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Calcium channel blocker; Overdose; High-insulin euglycaemic therapy

Cite this article

South African Medical Journal 2019;109(9):635-638. DOI:10.7196/SAMJ.2019.v109i9.13704

Article History

Date submitted: 2019-08-28
Date published: 2019-08-28

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