how does insulin treat calcium channel blocker overdose?
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High-dose insulin has become accepted as therapy in calcium channel blocker (CCB) toxicity refractory to standard vasopressor therapy. Hyperglycemia may occur in CCB toxicity, as calcium channel blockade inhibits insulin release.
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['taking too much diabetes medicine – especially too much insulin, medicines called sulphonylureas (such as glibenclamide and gliclazide) or medicines called glinides (such as repaglinide and nateglinide)', 'skipping or delaying a meal.']
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Thus, nifedipine may impair insulin secretion at high glucose levels in patients with NiDDM.
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Intravenous calcium to temporarily protect the heart and muscles from the effects of hyperkalemia. Sodium bicarbonate administration to counteract acidosis and to promote movement of potassium from the extracellular space back into the cells.
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Calcium entry blockers, or calcium channel blockers - CCBs for short - are vasodilators, or medications that promote dilation of blood vessels. These medications are mainly used to treat hypertension, or high blood pressure, and angina pectoris, which is a pain caused by reduced blood flow to the heart muscle.
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Glucagon promotes calcium entry into cells via stimulation of a receptor that is considered to be separate from adrenergic receptors. Note that the actions of glucagon oppose those of insulin, yet both have beneficial effects in treating CCB toxicity.
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NPH insulin. NPH insulin, also known as isophane insulin, is an intermediate–acting insulin given to help control blood sugar levels in people with diabetes. It is used by injection under the skin once to twice a day. Onset of effects is typically in 90 minutes and they last for 24 hours.
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Hepatic injury from calcium channel blockers is usually mild and reversible, but rare symptomatic and severe instances have been reported. Agents most clearly linked to liver injury are verapamil, diltiazem, amlodipine and nifedipine, probably because these agents have been most widely used.
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Taking insulin helps you manage your blood sugar levels. You take insulin by injecting it using an insulin pen, or by using an insulin pump. Pumps aren't available to everyone – only for people who have type 1 diabetes.
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Hypoglycemia Treatment You can take juice, hard candy, or glucose tablets. This will usually help your symptoms go away. Check your blood sugar again in 15 minutes and treat every 15 minutes if levels are still low. Call 911 if you don't feel well or if you can't get your blood sugar back up.
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Intravenous Administration Continuous IV infusion: Dilute nitroglycerin in 5% Dextrose Injection or 0.9% Sodium Chloride Injection to a final concentration of 200 to 400 mcg/mL depending on patient's fluid status. A common dilution is 50 mg in 250 mL of 5% Dextrose Injection or 0.9% Sodium Chloride Injection.
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Calcium channel blockers may be used to treat heart failure caused by high blood pressure when other medications to lower blood pressure do not work. Calcium channel blockers generally should not be used if you have heart failure due to systolic dysfunction.
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Patients on insulin known as NPH (Humulin N, Novolin N) are often reminded that they need to re-suspend it before use by shaking it or rolling it in the palm of their hand. However, doctors know that patients often hurry and don't take the time to mix up this kind of insulin before using it.
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Taking too much insulin can lead to hypoglycemia This can become particularly serious if your insulin dose was significantly more than it should have been.
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Patients with hyperkalemia and characteristic ECG changes should be given intravenous calcium gluconate. Acutely lower potassium by giving intravenous insulin with glucose, a beta2 agonist by nebulizer, or both. Total body potassium should usually be lowered with sodium polystyrene sulfonate (Kayexalate).
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2.4 Intravenous Use NovoLog can be administered intravenously under medical supervision for glycemic control with close monitoring of blood glucose and potassium levels to avoid hypoglycemia and hypokalemia [see Warnings and Precautions (5), How Supplied/Storage and Handling (16.2)].
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NPH insulin, also known as isophane insulin, is an intermediate-acting insulin given to help control blood sugar levels in people with diabetes. It is used by injection under the skin once to twice a day. Onset of effects is typically in 90 minutes and they last for 24 hours.