Case Report: This case series documents the clinical courses of 4 patients
after verapamil overdose and 1 patient after amlodipine-atenolol overdose.
All subjects had hypodynamic circulatory shock (hypotension, bradycardia, a
nd acidosis) that was not adequately responsive to conventional treatment.
After initiation of insulin-dextrose infusion, the hemodynamic status of al
l 5 patients stabilized and all patients survived, Plasma drug concentratio
ns are reported for all cases and verapamil levels were extremely high in 2
patients (3710 ng/mL and 3980 ng/mL), However, because patients were not t
reated according to a standard protocol, each patient received variable oth
er supportive measures and inotropic agents, and the infusion rates of insu
lin were variable among patients. This report provides preliminary evidence
toward a larger trial of insulin-dextrose to treat hypodynamic shock from
calcium channel blocker overdose.