The most common significant cardiotoxic overdoses involve non-dihydropyridine calcium channel blockers and beta-blockers. In this video, from our ICU Masterclass: Inotropes and Vasopressors course, we'll cover the mechanisms of toxicity and how specific agents can be used to revive patients who have overdosed on these medications.
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Providing hemodynamic support for unstable patients can be a daunting process. In our ICU Masterclass: Inotropes and Vasopressors course, you’ll learn a systematic, hands-on approach for using vasopressors and inotropes. You’ll discover why one size does not fit all, as well as the underlying mechanisms of action of these agents, so that you can safely and effectively use the appropriate agent for each unique patient.
The pathway for Mio site contraction may be interrupted in several places. The most common significant cardiotoxic overdoses are non dihydropyridine, calcium channel blockers, and beta blockers. calcium channel blockers like Delta's M and Verapamil interrupt the influx of calcium at the cell membrane, which can decrease heart rate and the strength of contraction.
This may be mitigated by aggressive calcium administration. In addition, glucagon may help create an alternate pathway for Mio sight contraction. epinephrine or other isotopes or vasopressors may be considered as adjunctive therapies as well. For refractory cases, high dose insulin and glucose infusion or intravenous liquid emotion may be considered and ultimately, mechanical circulatory support may be considered for recoverable cases.
Blockers on the Mio site blocked the influx of calcium through the calcium channel, but also blocked the increase in intracellular cyclic a MP. Again, this may be bypassed with the use of glucagon and calcium supplementation may be helpful in overdose. beta agonists like dobutamine isoproterenol, or epinephrine may help offset the receptor blocking effect. High dose insulin and glucose, limpid emotion or mechanical circulatory support are again considered for refractory cases.