Phys Vivas · pharmacological
Beta Blocker and Calcium Channel Blocker Toxicity — Viva Defence
DCE viva defence for Beta Blocker and Calcium Channel Blocker Toxicity.
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Target exams
Beta Blocker and Calcium Channel Blocker Toxicity Viva
Long Case Viva Defence
Opening statement
"This patient presents with a problem best framed as Beta Blocker and Calcium Channel Blocker Toxicity. My priorities are to identify red flags, confirm the mechanism with purposeful investigations, start a sequenced management plan, and integrate multimorbidity and follow-up." [1] [2]
Examiner questions
Q1: "What makes this urgent?" [1]
"I look for threats to airway, perfusion, neurology, metabolism, infection or bleeding, and I escalate those before elective work-up." [1] [2]
Q2: "What is your first investigation package?" [2]
"I order tests that change management now, not a scattergun panel." [1] [2]
Q3: "Walk me through treatment." [1]
"Stabilise, treat the mechanism, prevent complications, and plan monitoring." [1] [2] [3]
Q4: "What is the classic trap?" [2]
"Treating a label without confirming the discriminating mechanism, or delaying escalation." [1] [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