Resuscitation Review Blog
Toxicology

Beta-Blocker and Calcium Channel Blocker Overdose: Why Shock Becomes Metabolic

Beta-blocker and calcium channel blocker overdoses can both cause profound cardiovascular collapse.

But the shock is not only electrical or hemodynamic.

It is also metabolic.

Beta-blockers reduce heart rate, contractility, and AV nodal conduction. Some agents also block sodium channels or cross the blood-brain barrier, causing seizures or QRS widening.

Calcium channel blockers reduce calcium entry into cardiac and vascular smooth muscle cells. Non-dihydropyridines such as verapamil and diltiazem can cause bradycardia and myocardial depression. Dihydropyridines may cause profound vasodilation.

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