Phys Clinical Cases · pharmacological
Beta Blocker and Calcium Channel Blocker Toxicity — DCE Clinical Case
DCE long-case and short-case station for Beta Blocker and Calcium Channel Blocker Toxicity.
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Beta Blocker and Calcium Channel Blocker Toxicity — Clinical Case
DCE Long Case
Patient brief
Patient: A middle-aged or older adult with multimorbidity and a presentation centred on Beta Blocker and Calcium Channel Blocker Toxicity. [1]
Presenting complaint: Subacute or acute symptoms referable to Beta Blocker and Calcium Channel Blocker Toxicity, with enough detail to force prioritisation. [1] [2]
Past history: Common cardiometabolic and organ comorbidities that interact with the plan. [2]
Medications: A polypharmacy list that includes at least one interaction or dosing issue. [2]
Examination: Key positives and critical negatives for dangerous differentials. [1]
Investigations: A small set of results that change management. [1] [2]
Tasks
- Present a prioritised problem list. [1]
- Defend investigations and immediate therapy. [1] [2]
- Provide safety-net and follow-up advice. [2]
Model discussion points
- Working diagnosis and acuity. [1]
- Differentials and discriminators. [2]
- Treatment sequence and monitoring. [1] [2] [3]
- Multimorbidity and communication. [2]
References6ShowHide
- [1]Meamar R, Samsamshariat S, Dorvashi G, Feizi A, et al. Intravenous Lipid Emulsion in Beta-Blocker With or Without Calcium Channel Blocker Toxicity: A Systematic Review of Human Case Reports and Series J Appl Toxicol, 2026.PMID 42365995
- [2]St-Onge M, Anseeuw K, Cantrell FL, et al. Experts Consensus Recommendations for the Management of Calcium Channel Blocker Poisoning in Adults Crit Care Med, 2017.PMID 27749343
- [3]Suarez F, Koyfman A, Long B Pearls and Pitfalls for the Emergency Clinician: Beta Blocker and Calcium Channel Blocker Toxicity J Emerg Med, 2026.PMID 41833262
- [4]Lavonas EJ, Akpunonu PD, Arens AM, Babu KM, et al. 2023 American Heart Association Focused Update on the Management of Patients With Cardiac Arrest or Life-Threatening Toxicity Due to Poisoning: An Update to the American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Circulation, 2023.PMID 37721023
- [5]Lindeman E, Baer Eriksson L, Thorsson M, Nordmark Grass J [High dose insulin euglycemia therapy – an important addition to the treatment arsenal in severe toxic myocardial depression] Lakartidningen, 2017.PMID 28994852
- [6]Darracq MA, Thornton SL, Do HM, Bok D, et al. Utilization of hyperinsulinemia euglycemia and intravenous fat emulsion following poison center recommendations J Med Toxicol, 2013.PMID 23412936