Key result
High-dose insulin euglycemia therapy and bicarbonate manage refractory shock from polypharmacy overdose.
Case Report (n=1)
No
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High-dose insulin euglycemia therapy alongside bicarbonate and vasopressors can be utilized to manage refractory shock resulting from combined TCA, CCB, and ACE inhibitor overdose.
We are presenting the case of a 28‐year‐old female patient who presented with refractory shock secondary to overdose of tricyclic antidepressants, calcium channel blockers (CCBs) and angiotensin‐converting enzyme inhibitors. After initial resuscitation, bicarbonate infusion for TCA toxicity was used; and CCB toxicity was managed with high‐dose insulin euglycemia therapy (HIET) with simultaneous dextrose infusion and vasopressors in the intensive care unit.
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Rehman et al. (2026) conducted a case report in Polypharmacy toxicity (TCA, CCB, ACE inhibitor overdose) with refractory shock (n=1). Bicarbonate infusion, high-dose insulin euglycemia therapy (HIET), dextrose infusion, and vasopressors was evaluated. A 28-year-old female with refractory shock from polypharmacy overdose was managed with bicarbonate infusion, high-dose insulin euglycemia therapy, dextrose, and vasopressors.
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