• E A Ramoska, H A Spiller, M Winter, and D Borys.
• Division of Emergency Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
• Ann Emerg Med. 1993 Feb 1;22(2):196-200.

Study ObjectiveTo examine the cardiovascular toxicity of calcium channel blockers and the efficacy of various treatments.DesignCase series collected prospectively over one year.SettingThree regional poison control centers.Type Of ParticipantsOne hundred thirty-nine hospitalized patients who had ingested a calcium channel blocker.InterventionsCalcium, dopamine, atropine, isoproterenol, glucagon, and pacemakers.Main ResultsHypotension, sinus node suppression, and dysrhythmias often occur with calcium channel blocker overdoses, but atrioventricular nodal block occurs more often with verapamil (chi 2 test, P < .025). Calcium was administered to 23 patients and was efficacious in reversing depression of cardiac conduction and increasing blood pressure. Dopamine was administered to ten patients and was efficacious in increasing blood pressure. Atropine was administered to eight patients, but only two had a positive response.ConclusionAtrioventricular nodal depression is more common with verapamil overdoses. Calcium and dopamine are useful in treating toxicity from calcium channel blocker overdose, whereas atropine is sometimes useful.

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