Calcium channel blockers

Overdose of calcium channel blockers is potentially lethal. Heart block with marked bradycardia and hypotension are the most important features in overdose. Verapamil and diltiazem are much more dangerous than dihydropyridines. Routine management usually includes IV fluids, activated charcoal, whole bowel irrigation (for controlled-release products) and prolonged ECG monitoring. Antidotes for cardiac effects include calcium, atropine, bicarbonate, insulin, glucagon and vasopressors.