The Use of High-dose Insulin Infusion and Lipid Emulsion Therapy in Concurrent Beta-blocker and Calcium Channel Blocker Overdose

Patients admitted with the presumed coingestion of beta-blockers (BBs) and calcium channel blockers (CCBs) should be initially managed in accordance with standardized resuscitation protocols (the airway, breathing, and circulation (ABC) approach). Additionally, more specific interventions should be...

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Autores principales: Lashari, Bilal H, Minalyan, Artem, Khan, Waqas, Naglak, Mary, Ward, William
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2018
Materias:
Anesthesiology
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6318115/
https://www.ncbi.nlm.nih.gov/pubmed/30648068
http://dx.doi.org/10.7759/cureus.3534
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author Lashari, Bilal H
Minalyan, Artem
Khan, Waqas
Naglak, Mary
Ward, William
author_facet Lashari, Bilal H
Minalyan, Artem
Khan, Waqas
Naglak, Mary
Ward, William
author_sort Lashari, Bilal H
collection PubMed
description Patients admitted with the presumed coingestion of beta-blockers (BBs) and calcium channel blockers (CCBs) should be initially managed in accordance with standardized resuscitation protocols (the airway, breathing, and circulation (ABC) approach). Additionally, more specific interventions should be promptly attempted. Intravenous glucagon and calcium salts have long been used in the treatment of BB and CCB toxicities. We present a case of a severe, concurrent BB and CCB toxicity resulting in cardiovascular collapse refractory to vasopressors. The administration of high-dose insulin (HDI) and lipid emulsion therapy (LET) resulted in a significant improvement in hemodynamics with an overall favorable outcome in the patient.
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spelling pubmed-63181152019-01-15 The Use of High-dose Insulin Infusion and Lipid Emulsion Therapy in Concurrent Beta-blocker and Calcium Channel Blocker Overdose Lashari, Bilal H Minalyan, Artem Khan, Waqas Naglak, Mary Ward, William Cureus Anesthesiology Patients admitted with the presumed coingestion of beta-blockers (BBs) and calcium channel blockers (CCBs) should be initially managed in accordance with standardized resuscitation protocols (the airway, breathing, and circulation (ABC) approach). Additionally, more specific interventions should be promptly attempted. Intravenous glucagon and calcium salts have long been used in the treatment of BB and CCB toxicities. We present a case of a severe, concurrent BB and CCB toxicity resulting in cardiovascular collapse refractory to vasopressors. The administration of high-dose insulin (HDI) and lipid emulsion therapy (LET) resulted in a significant improvement in hemodynamics with an overall favorable outcome in the patient. Cureus 2018-11-01 /pmc/articles/PMC6318115/ /pubmed/30648068 http://dx.doi.org/10.7759/cureus.3534 Text en Copyright © 2018, Lashari et al. http://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Anesthesiology
Lashari, Bilal H
Minalyan, Artem
Khan, Waqas
Naglak, Mary
Ward, William
The Use of High-dose Insulin Infusion and Lipid Emulsion Therapy in Concurrent Beta-blocker and Calcium Channel Blocker Overdose
title The Use of High-dose Insulin Infusion and Lipid Emulsion Therapy in Concurrent Beta-blocker and Calcium Channel Blocker Overdose
title_full The Use of High-dose Insulin Infusion and Lipid Emulsion Therapy in Concurrent Beta-blocker and Calcium Channel Blocker Overdose
title_fullStr The Use of High-dose Insulin Infusion and Lipid Emulsion Therapy in Concurrent Beta-blocker and Calcium Channel Blocker Overdose
title_full_unstemmed The Use of High-dose Insulin Infusion and Lipid Emulsion Therapy in Concurrent Beta-blocker and Calcium Channel Blocker Overdose
title_short The Use of High-dose Insulin Infusion and Lipid Emulsion Therapy in Concurrent Beta-blocker and Calcium Channel Blocker Overdose
title_sort use of high-dose insulin infusion and lipid emulsion therapy in concurrent beta-blocker and calcium channel blocker overdose
topic Anesthesiology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6318115/
https://www.ncbi.nlm.nih.gov/pubmed/30648068
http://dx.doi.org/10.7759/cureus.3534
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