Thursday, June 24, 2010

Euglycemic hyperinsulinemia therapy for severe calcium blocker overdose

---and maybe beta blocker overdose has been the well kept secret among toxicology types for a decade. Supported primarily by animal data, physiologic rationale and case reports (many of which are dramatic), it is gradually emerging as an important component of treatment when the overdose is severe. Accumulating dramatic case reports support current use---we will probably not see higher level evidence. This review (accompanying commentary here) is probably the best evidence summary available. The authors advocate using it along side of (adjunct) rather than after failure of, more standard measures such as pressors, inotropes, glucagon, calcium salts, etc.

Commentary here from Emergency Medicine News.

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