calcium channel blocker/beta blocker OD

[TXmed]

I understand that you must give both calcium and glucagon for both overdoses . But can someone explain the patho behind this ?

 

[DrankTheKoolaid]

Listen to emcrit.org podcast about these 2 overdoses and you will realize why glucagon in the doses we carry and CA won't work the way we were told.

 

[J B]

Those are both medical control options under my protocols and definitely not "must give"'s.

This article is pretty dense but pretty much covers everything you might want to know about the physiology involved and different approaches to treatment:
http://emcrit.org/wp-content/uploads/ccb.pdf

 

[VFlutter]

Listen to emcrit.org podcast about these 2 overdoses and you will realize why glucagon in the doses we carry and CA won't work the way we were told.

I have only seen a Glucagon drip used for BB overdose once. Pharmacy was not happy.

 

[Handsome Robb]

OP read up on the second messenger system.

Basically glucagon increases cAMP through a system I don't want to type all the way out in the heart and bypasses the beta-adrenergic SMS which is under a beta blockade due to the BBOD.

It requires more than any agency I've heard of carrying and there's not really much if any real data to prove it works.

 

[Carlos Danger]

Large doses of insulin are being used as well.

 

[DieselBolus17]

With calcium blocker overdoses you are essentially dilating arteries and taking the contractility of the heart and bottoming out their BP, also calcium is needed for nerve conduction of the heart. With beta blocker overdoses it's kind of the same thing as a calcium over dose but effects are primarily seen at the heart if a selective beta 1 blocker is used, or both the heart and arteries if a non selective beta blocker is used, causing low HR, BP, contractility, vasodilation, and thss reducing cardiac output. Calcium is given to reverse the calcium channel blocker effects, causing vasoconstriction, increase force of contractions, increasing CO.