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Previous Volume 344:1721-1722 May 31, 2001 Number 22 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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To the Editor: Overdose of calcium-channel blockers remains an important cause of fatal poisoning.¹ Conventional therapy, consisting of intravenous fluids, calcium, dopamine, dobutamine, norepinephrine, and glucagon, often fails to improve hemodynamic function in intoxicated patients.² Recent recommendations for treatment of intoxication with calcium-channel blockers include induction of hyperinsulinemia and euglycemia as adjunctive therapy.³ We report two cases of overdose of calcium-channel blockers in which a striking benefit was achieved with hyperinsulinemia–euglycemia therapy.

A 34-year-old nondiabetic woman with hypertension and renal failure ingested 12 extended-release tablets containing 2.5 mg of amlodipine each. Hypotension and bradycardia developed. Because of her history of . . . [Full Text of this Article]

References

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• Patel, N. P., Pugh, M. E., Goldberg, S., Eiger, G. (2007). Hyperinsulinemic Euglycemia Therapy for Verapamil Poisoning: A Review. Am J Crit Care 16: 498-503 [Abstract] [Full Text]  
• Patel, N. P., Pugh, M. E., Goldberg, S., Eiger, G. (2007). Hyperinsulinemic Euglycemia Therapy for Verapamil Poisoning: Case Report. Am J Crit Care 16: 520-518 [Abstract] [Full Text]  
• Harris, N. S. (2006). Case 24-2006 -- A 40-Year-Old Woman with Hypotension after an Overdose of Amlodipine. NEJM 355: 602-611 [Full Text]  
• Hedge, M. (2005). Calcium Channel Blocker Toxicology. Journal of Pharmacy Practice 18: 169-174 [Abstract]  
• Shepherd, G., Klein-Schwartz, W. (2005). High-Dose Insulin Therapy for Calcium-Channel Blocker Overdose. The Annals of Pharmacotherapy 39: 923-930 [Abstract] [Full Text]  
• Fatovich, D. M (2002). Recent developments: Emergency medicine. BMJ 324: 958-962 [Full Text]