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Beta Blocker/Calcium Channel Blocker Overdose 

Beta Blocker/Calcium Channel Blocker Overdose
Beta Blocker/Calcium Channel Blocker Overdose

Christopher L. Cropsey

, and Patrick B. Knight

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date: 19 June 2021

Beta blocker and calcium channel blocker overdose is a rare perioperative complication that manifests with symptoms of altered mental status, hypotension, bradycardia, and cardiovascular collapse. Although the clinical presentation is often similar, the underlying pathophysiology can differ between either cardiogenic or vasodilatory shock. Standard therapies such as calcium administration or beta-adrenergic agonists may be effective but often require much higher doses than normal. The evidence for targeted therapies, such as high-dose insulin infusion and glucagon, is mixed, but these should be considered. Refractory toxicity may require advanced lifesaving measures such as intra-arterial balloon counterpulsation or extracorporeal membrane oxygenation. If prompt cardiovascular support can be achieved, patient outcomes are generally very positive.

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