A 40-year-old woman is admitted to ICU following an intentional overdose of sustained-release verapamil. She is bradycardic (HR 30 bpm), hypotensive (...

Question

A 40-year-old woman is admitted to ICU following an intentional overdose of sustained-release verapamil. She is bradycardic (HR 30 bpm), hypotensive (BP 60/30 mmHg), and has a blood glucose of 2.5 mmol/L. She has not responded to IV calcium chloride or IV glucagon. What rescue therapy should be considered?

Accepted Answer

High-dose insulin euglycaemic therapy (HIET) - IV insulin bolus 1 unit/kg followed by 0.5-2 units/kg/hr infusion with dextrose

Answer

IV sodium bicarbonate 8.4%

Answer

IV lipid emulsion 20% (Intralipid) - 1.5 mL/kg bolus followed by infusion

Answer

IV N-acetylcysteine

Answer

Therapeutic hypothermia

uk-fficm MCQ (SBA): Calcium Channel Blocker Overdose