Compare and contrast the clinical features and management of a patient following beta blocker overdose with those of a patient following calcium-channel blocker overdose.
Beta-blockers |
Ca channel blockers |
|
General |
Clinical features depend |
Varying CVS effects |
CVS |
Hypotension, |
Hypotension, bradycardia |
CCF |
||
Other systems |
Bronchospasm, |
Hyperglycemia, nausea |
Treatment |
Charcoal, fluids, Beta |
Charcoal, IV fluids, IV |
Though satisfactory, the college answer lacks qualities which help the studying candidate generate some memory of the differences between these drugs. The table below builds on the college answer by highlighting in bold the key differences between these overdoses.
|
Calcium channel blocker overdose |
Beta-blocker overdose |
Clinical features |
Bradycardia |
Bradycardia |
Management: |
||
Antidote |
Ionised calcium (eg. calcium chloride) |
Glucagon |
Decontamination |
Activated charcoal |
Activated charcoal |
Enhancement of clearance |
Hemoperfusion for verapimil |
Hemoperfusion for metoprolol |
DeWitt, Christopher R., and Javier C. Waksman. "Pharmacology, pathophysiology and management of calcium channel blocker and β-blocker toxicity." Toxicological reviews 23.4 (2004): 223-238.