What is the role of dextrose in the treatment of calcium channel blocker (CCB) toxicity?

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

Glucose:

  • Most patients with CCB toxicity present with hyperglycemia and their initial glucose requirements to maintain euglycemia are minimal (due to insulin resistance); however, as organ perfusion improves, the offending drug is metabolized, and insulin resistance abates, dextrose requirements increase

  • The mean maximum dextrose requirement was 24 g/h (range, 0.5-75 g/h)
  • Mean duration of dextrose infusion is 46 hours (range, 12-100 h)

  • Exogenous dextrose is often required even after insulin infusion is stopped

  • Intubated patients are at greatest risk of undetected hypoglycemia since they cannot demonstrate typical signs of hypoglycemia, and bedside fingerstick glucose should be checked every 15-30 minutes


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