Calcium Channel Blocker Overdose — RACP Adult Medicine MCQ
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Correct answer: D — High-dose insulin with dextrose titrated to haemodynamic response
The best answer is “High-dose insulin with dextrose titrated to haemodynamic response”. High-dose insulin-euglycaemia therapy improves myocardial carbohydrate use and contractility in severe calcium-channel-blocker poisoning. Dextrose and potassium are monitored and replaced while vasopressors and other rescue measures are added according to physiology. Lipid emulsion is a selected rescue option, glucagon is more often considered in beta-blocker toxicity, and bicarbonate targets sodium-channel blockade rather than isolated verapamil shock.
Reference: NSW Agency for Clinical Innovation: Toxicology resources: https://aci.health.nsw.gov.au/networks/eci/clinical/clinical-resources/toxicology