EMCrit 264 – Case Discussion of Combined CCB and BB Overdose

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Today, we discuss a case of a patient who 45 mintues prior to arrival took took 150 Labetalol 100mg and 70 Amlodipine 10mg.

Prior EMCrit Podcast

* EMCrit Podcast - Calcium Channel Blocker Overdose

Hemodynamically Neutral Intubation

* See this EMCrit Podcast

3 Presentations for CCB or BB OD

* Vasodilatory

* Negative-Inotropy (& Chronotropy)

* Combined Picture

Vasopressor-Only Management

For me this is only appropriate for primarily vasodilatory shock (PMID 23642908, Skoog et al., Levine et al.)

Tum-E-Vac Commercial Device for Gastric Lavage

If you believe in lavage...

from manufacturer site

Prior Post on Calcium Channel Blocker OD

* EMCrit Podcast 27

Extrip on CCB

Both dialyzability and clinical data do not support a clinical benefit from ECTRs for CCB poisoning. The EXTRIP workgroup recommends against using extracorporeal methods to enhance the elimination of amlodipine, diltiazem, and verapamil in patients with severe poisoning. [10.1080/15563650.2020.1870123]

Tox & Hound on Mechanism of Insulin

* Insulin for CCB/BB OD

Now on to the Podcast...