ReviewCritical care (London, England)2006
Bench-to-bedside review: hyperinsulinaemia/euglycaemia therapy in the management of overdose of calcium-channel blockers.
Review in Critical care (London, England), 2006. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers.
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Who cites it
28 citing papers in PubMed, 93 citations in OpenAlex.
- Insulin augments vasodilatory response elicited by amlodipine via nitric oxide-dependent vasodilation in isolated rat aortas.Korean journal of anesthesiology · 2026Article
- Severe Diltiazem Poisoning Managed With CytoSorb Hemoadsorption and Supportive Therapies: A Case Report.Critical care explorations · 2026Article
- Competing therapy options for severe amlodipine poisoning-lessons learned: a case report.Journal of medical case reports · 2026Article
- Management of a Patient With Polypharmacy Toxicity (Calcium Channel Blocker, Angiotensin Converting Enzyme Inhibitor and Tricyclic Antidepressant) in Intensive Care Settings: A Case Report.Case reports in anesthesiology · 2026Article
- Fifty-Four Tablets Too Many: A Case Report of Amlodipine and Losartan Overdose.Clinical case reports · 2025Article
- Article
- Successful treatment of severe calcium channel blocker poisoning, new experience with the guidance of invasive hemodynamic monitoring in a 17-year-old girl: a case report.Journal of medical case reports · 2024Article
- Antidotes in Clinical Toxicology-Critical Review.Toxics · 2023Review
- Hyperinsulinemia/euglycemia and intravenous lipid emulsion therapy for the management of severe amlodipine toxicosis in a cat.Clinical case reports · 2021Article
- Extracorporeal cardiopulmonary resuscitation for the treatment of amlodipine overdose in a pediatric patient.Journal of surgical case reports · 2021Article
- Extracorporeal Membrane Oxygenation in Drug Overdose: A Clinical Case Series.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2018Article
- Critical Management of Severe Hypotension Caused by Amlodipine Toxicity Managed With Hyperinsulinemia/Euglycemia Therapy Supplemented With Calcium Gluconate, Intravenous Glucagon and Other Vasopressor Support: Review of Literature.Cardiology research · 2018Article
- A multifaceted approach to calcium channel blocker overdose: a case report and literature review.Clinical case reports · 2015Article
- Before and After Study of Pharmacists' and Students' Knowledge of Two Novel Antidotes: High-Dose Insulin Euglycemia and Intravenous Fatty Acid Emulsion 20.Hospital pharmacy · 2015Article
- High dose insulin therapy, an evidence based approach to beta blocker/calcium channel blocker toxicity.Daru : journal of Faculty of Pharmacy, Tehran University of Medical Sciences · 2014Article
- Amlodipine overdose.Proceedings (Baylor University. Medical Center) · 2013Article
- Near fatal case of amlodipine poisoning in an infant.Indian journal of pediatrics · 2013Article
- Severe diltiazem poisoning treated with hyperinsulinaemia-euglycaemia and lipid emulsion.Case reports in critical care · 2013Article
- Life-threatening calcium channel blocker overdose and its management.BMJ case reports · 2012Article
- Utility of the electrocardiogram in drug overdose and poisoning: theoretical considerations and clinical implications.Current cardiology reviews · 2012Review
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Hyperinsulinaemia/euglycaemia therapy (HIET) consists of the infusion of high-dose regular insulin (usually 0.5 to 1 IU/kg per hour) combined with glucose to maintain euglycaemia. HIET has been proposed as an adjunctive approach in the management of overdose of calcium-channel blockers (CCBs). Indeed, experimental data and clinical experience, although limited, suggest that it could be superior to conventional pharmacological treatments including calcium salts, adrenaline (epinephrine) or glucagon. This paper reviews the patho-physiological principles underlying HIET. Insulin administration seems to allow the switch of the cell metabolism from fatty acids to carbohydrates that is required in stress conditions, especially in the myocardium and vascular smooth muscle, resulting in an improvement in cardiac contractility and restored peripheral resistances. Studies in experimental verapamil poisoning in dogs have shown that HIET significantly improves metabolism, haemodynamics and survival in comparison with conventional therapies. Clinical experience currently consists only of a few isolated cases or short series in which the administration of HIET substantially improved cardiovascular conditions in life-threatening CCB poisonings, allowing the progressive discontinuation of vasoactive agents. While we await further well-designed clinical trials, some rational recommendations are made about the use of HIET in severe CBB overdose. Although the mechanism of action is less well understood in this condition, some experimental data suggesting a potential benefit of HIET in beta-adrenergic blocker toxicity are discussed; clinical data are currently lacking.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.