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Calcium channel blocker overdose — ABEM Board MCQ

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HardToxicologyCalcium channel blocker overdoseABEM Board

A 63-year-old woman arrives after ingesting extended-release verapamil. Triage acuity is ESI 1; BP 62/36 mm Hg, HR 38/min, glucose 286 mg/dL. She is confused and cool despite IV fluids. ECG shows sinus bradycardia with first-degree AV block. Which of the following is the most appropriate initial action?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Give IV calcium and initiate high-dose insulin euglycemia therapy

Calcium channel blocker overdose causes bradycardic shock and hyperglycemia; treatment includes calcium, vasopressors, and high-dose insulin euglycemia therapy.

Reference: ACMT calcium channel blocker poisoning guidance