What is the first-line treatment for an overdose involving calcium channel blockers?

In the context of a calcium channel blocker overdose, the primary issue is the resulting cardiovascular effects, such as hypotension and bradycardia, as well as potential conduction abnormalities. The correct first-line treatment involves the administration of calcium salts, specifically calcium chloride.

Calcium chloride is effective because it helps to counteract the negative inotropic effects and vasodilation caused by calcium channel blocker toxicity. By providing additional calcium, it can restore myocardial contractility and improve vascular tone, thus stabilizing the patient’s hemodynamic status.

In addition to calcium itself, other supportive measures like intravenous fluids, vasopressors, and possibly glucagon can be used in conjunction, but calcium chloride remains the cornerstone of treatment. This choice is solidified by its role in directly addressing the pathophysiological changes induced by the overdose. While dantrolene, glucagon, and sodium bicarbonate can have roles in various toxicity scenarios or other types of overdoses, they are not the primary agents for calcium channel blocker toxicity.