Podcast #323: Calcium Channel Toxicity

Podcast #323: Calcium Channel Toxicity

Author: Jared Scott, M.D.

Educational Pearls:

  • Cardiac myocytes and vascular smooth muscle are dependent on an intracellular calcium influx for contraction. Pancreatic beta cells rely on calcium to release insulin.
  • Calcium channel blockers will decrease cardiac contractility and heart rate, but will also cause vascular smooth muscle relaxation with a subsequent decrease in systemic vascular resistance.
  • Resultant cardiac depression and hypotension.
  • Pancreatic beta cells also use calcium to release insulin, so calcium channel blockade can cause hyperglycemia.
  • Treatment for calcium channel toxicity include: fluid resuscitation, calcium gluconate, vasopressors, and high dose insulin.
  • Dosing for insulin therapy is usually 1-5 Units/kg/hr. Make sure to add dextrose!

References:

Boyer EW, Shannon M. (2001).Treatment of calcium-channel-blocker intoxication with insulin infusion. New England Journal of Medicine. 344:1721.

Proano L, Chiang WK, Wang RY. (1995).Calcium channel blocker overdose. American Journal of Emergency Medicine. 13:444.

St-Onge M, Dubé PA, Gosselin S, et al. (2014). Treatment for calcium channel blocker poisoning: a systematic review. Clinical Toxicology. 52:926.

Avsnitt(1145)

Podcast 656: Rashes

Podcast 656: Rashes

Contributor:  Peter Bakes, MD Educational Pearls: Lyme disease gives a single expanding target lesion with central clearing called erythema chronicum migrans Erythema multiforme is another targetoid ...

7 Apr 20217min

Podcast 655: Hypothermia in Sepsis

Podcast 655: Hypothermia in Sepsis

Contributor: Adam Barkin, MD Educational Pearls: Fever is an adaptive response to infection, but elderly and immunocompromised patients may not be able to mount a hyperthermic response in sepsis Pati...

6 Apr 20213min

Podcast 654: Depression in COVID

Podcast 654: Depression in COVID

Contributor: Aaron Lessen, MD Educational Pearls: Survey study compared depression symptom prevalence in the United States at the beginning of COVID compared to data acquired by a similar survey for...

5 Apr 20213min

Podcast 653: Nitroglycerin Disimpaction

Podcast 653: Nitroglycerin Disimpaction

Contributor: Ricky Dhaliwal, MD, JD Educational Pearls: Glucagon administered intravenously has a high rate of adverse events (nausea/vomiting) with very weak evidence NItroglycerin too has very lim...

30 Mars 20212min

Podcast 652: Prosthetic Hip Dislocation

Podcast 652: Prosthetic Hip Dislocation

Contributor: Jared Scott, MD Educational Pearls: While it is rare to have a native hip dislocation, it is relatively common to dislocate a prosthetic hip The mechanism for dislocation is usually add...

29 Mars 20215min

Dr. Don Stader Shares Personal Experience of Losing his Mother to COVID-19 and Ruminates on the Culture of Death in Medicine (UnfilterED #12 Excerpt)

Dr. Don Stader Shares Personal Experience of Losing his Mother to COVID-19 and Ruminates on the Culture of Death in Medicine (UnfilterED #12 Excerpt)

A heartfelt excerpt from our most recent UnfilterED episode with Dr. Don Stader.

26 Mars 202120min

Podcast 651: Hereditary Angioedema

Podcast 651: Hereditary Angioedema

Contributor: Katie Sprinkel, MD Educational Pearls: Hereditary angioedema (HA) is an autosomal dominant bradykinin-mediated disease affecting the airway, skin or gastrointestinal tract and typically...

23 Mars 202110min

Podcast 650: PNES

Podcast 650: PNES

Contributor: Katie Sprinkel, MD Educational Pearls: Psychogenic Non-Epileptic Seizures (PNES) are due to a psychogenic rather than an epileptic cause Despite common assumption, PNES are not always v...

22 Mars 20216min

Populärt inom Vetenskap

p3-dystopia
dumma-manniskor
svd-nyhetsartiklar
allt-du-velat-veta
kapitalet-en-podd-om-ekonomi
det-morka-psyket
pojkmottagningen
dumforklarat
rss-vetenskapsradion
rss-vetenskapsradion-2
sexet
halsorevolutionen
rss-ufo-bortom-rimligt-tvivel
rss-experimentet
rss-broccolipodden-en-podcast-som-inte-handlar-om-broccoli
rss-spraket
medicinvetarna
bildningspodden
vetenskapsradion
rss-lara-fran-larda-en-fackbok-och-en-forfattare