CCB and B-blocker and Iron Toxicity

CCB signs and symptoms

hyperglycemia
metabolic acidosis
pulmonary edema
ileus (SR)

B-blocker signs and symptoms

hypoglycemia
bronchospasms

both signs and symptoms

hypotension
bradycardia
arrhythmias
cardiogenic shock
CNS depression

treatment options

activated charcoal
atropine
calcium
vasopressors
glucagon
high dose insulin therapy
lipid emulsion therapy

not a reversal agent, usually ineffectice

atropine

more effectice for CCB

calcium

vasopressor options

norepinephrine
epinephrine

vasodilatory shock

norephinephrine

cardiogenic shock

epinephrine

which requires higher doses of vasopressors

B-blockers

may need to premedication with N/V medications

glucagon

can cause tachyphylaxis

glucagon

iron toxicity treatment

PEG
deferoxamine

when is deferoxamine indicated

metabolic acidosis
shock
clinical deterioration
iron in KUB
concentration > 500