How are asymptomatic patients with significant exposure to calcium channel blockers (CCBs) treated?

Updated: Jan 04, 2021
  • Author: B Zane Horowitz, MD, FACMT; Chief Editor: Michael A Miller, MD  more...
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Answer

Basic supportive care is the first, and possibly most important, mode of management for CCB toxicity: Stabilize airway, breathing, and circulation (ABCs). Correction of acid-base disturbances and electrolyte abnormalities is also important, to optimize cardiac function.

Generally, the recommended duration of clinical observation for asymptomatic patients with significant exposure to CCBs is as follows [2, 3] :

  • Immediate-release products: 6 hours
  • Standard-release products: 6-12 hours
  • Extended-release or once-a-day preparations: 24-36 hours

In cases of intentional overdose, patients who remain asymptomatic after an adequate observation time may be referred for psychiatric evaluation.

Activated charcoal has been demonstrated to significantly absorb immediate-release medications within 1 hour of ingestion and extended-release medications as long as 4 hours after ingestion. [4] Before administration of activated charcoal, protect the patient's airway to prevent vomiting and aspiration.


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