{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T12:15:41Z","timestamp":1768997741195,"version":"3.49.0"},"reference-count":43,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2014,5,23]]},"abstract":"<jats:p>We describe a case of extreme mixed overdose of calcium channel blockers, \u03b2-blockers and statins. The patient was successfully treated with aggressive resuscitation including cardiac pacing and multiorgan support, glucagon and high-dose insulin for toxicity related to calcium channel blockade and \u03b2-blockade, and ubiquinone for treating severe presumed statin-induced rhabdomyolysis and muscle weakness.<\/jats:p>","DOI":"10.1136\/bcr-2014-204732","type":"journal-article","created":{"date-parts":[[2014,6,6]],"date-time":"2014-06-06T07:36:19Z","timestamp":1402040179000},"page":"bcr2014204732","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":7,"title":["Management of a mixed overdose of calcium channel blockers, \u03b2-blockers and statins"],"prefix":"10.1136","volume":"2014","author":[{"given":"Reena","family":"Thakrar","sequence":"first","affiliation":[{"name":"Department of Critical Care, University College London Hospital Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rob","family":"Shulman","sequence":"additional","affiliation":[{"name":"Pharmacy Department, University College London Hospital Foundation Trust, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Geoff","family":"Bellingan","sequence":"additional","affiliation":[{"name":"Department of Critical Care, University College London Hospital Foundation Trust, London, UK"},{"name":"Bloomsbury Institute of Intensive Care Medicine, University College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mervyn","family":"Singer","sequence":"additional","affiliation":[{"name":"Bloomsbury Institute of Intensive Care Medicine, University College London, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2014,6,6]]},"reference":[{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.1","doi-asserted-by":"publisher","DOI":"10.2146\/ajhp060041"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.2","doi-asserted-by":"publisher","DOI":"10.3109\/15563659609013789"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.3","first-page":"2981","article-title":"[Case of severe rhabdomyolsis after protracted overdose of simvastatin]","volume":"170","author":"Greve","year":"2008","journal-title":"Ugeskr Laeger"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-6147(99)01322-X"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.5","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1016\/S0733-8627(20)30433-8","article-title":"Beta-blocker and calcium channel blocker toxicity","volume":"12","author":"Kerns","year":"1994","journal-title":"Emerg Med Clin North Am"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.6","doi-asserted-by":"publisher","DOI":"10.2165\/00002018-200326020-00001"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.7","unstructured":"National Poisons Information Service. Bisoprolol fumarate. Toxbase. April 2010. http:\/\/www.toxbase.org\/Poisons-Index-A-Z\/B-Products\/Bisoprolol-Fumarate (accessed Dec 2013)."},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.8","doi-asserted-by":"publisher","DOI":"10.1016\/j.resuscitation.2009.01.023"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.9","doi-asserted-by":"publisher","DOI":"10.1081\/CLT-120023761"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.10","doi-asserted-by":"publisher","DOI":"10.1177\/096032719601500509"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.11","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(05)80202-1"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.12","doi-asserted-by":"publisher","DOI":"10.1081\/CLT-100102437"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.13","doi-asserted-by":"publisher","DOI":"10.1016\/0736-4679(91)90380-X"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.14","doi-asserted-by":"publisher","DOI":"10.1097\/00003246-199507000-00016"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.15","doi-asserted-by":"publisher","DOI":"10.3109\/15563650.2011.582471"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.16","doi-asserted-by":"publisher","DOI":"10.1016\/S0008-6363(97)00022-9"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.17","doi-asserted-by":"publisher","DOI":"10.1172\/JCI110572"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.18","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(97)70196-3"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.19","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1E436"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.20","doi-asserted-by":"crossref","first-page":"39","DOI":"10.1159\/000074241","article-title":"Amlodipine increases endothelial nitric oxide by dual mechanism","volume":"70","author":"Berkles","year":"4004","journal-title":"Pharmacology"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.21","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.308.6935.992"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.22","first-page":"24","article-title":"HMG-CoA reductase inhibitors for treatment of hypercholesterolemia","volume":"319","author":"Grundy","year":"1998","journal-title":"N Engl J Med"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.23","doi-asserted-by":"publisher","DOI":"10.1038\/343425a0"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.24","doi-asserted-by":"publisher","DOI":"10.1007\/s10557-005-5686-z"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.25","doi-asserted-by":"publisher","DOI":"10.1006\/taap.1997.8131"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.26","doi-asserted-by":"publisher","DOI":"10.1097\/00001648-200109000-00017"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.27","doi-asserted-by":"publisher","DOI":"10.1152\/ajpcell.00226.2006"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.28","doi-asserted-by":"publisher","DOI":"10.1001\/jama.289.13.1681"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.29","doi-asserted-by":"publisher","DOI":"10.2165\/00002018-200629010-00002"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.30","doi-asserted-by":"publisher","DOI":"10.1016\/j.clpt.2005.03.006"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.31","doi-asserted-by":"crossref","first-page":"1049","DOI":"10.1016\/j.amjcard.2006.12.063","article-title":"Effect of co-enzyme Q10 on myopathic symptoms in patients treated with statins","volume":"99","author":"Caso","year":"2007","journal-title":"Am J Cardiol"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.32","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2007.02.049"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.33","doi-asserted-by":"publisher","DOI":"10.1016\/j.clpt.2005.03.006"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.34","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.87.22.8931"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.35","first-page":"324","article-title":"Effect of treatment with 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors on serum coenzyme Q10 in diabetic patients","volume":"49","author":"Miyake","year":"1999","journal-title":"Arzneimittelforschung"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.36","doi-asserted-by":"crossref","unstructured":"Bargossi AM Grossi G Fiorella PL . Exogenous CoQ10 supplementation prevents plasma ubiquinone reduction induced by HMG-CoA reductase inhibitors. Mol Aspects Med 1994;(15 Suppl):s187\u201393.","DOI":"10.1016\/0098-2997(94)90028-0"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.37","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2004.07.121"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.38","doi-asserted-by":"publisher","DOI":"10.1081\/CLT-100100932"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.39","doi-asserted-by":"publisher","DOI":"10.1023\/A:1006481423298"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.40","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2006.12.063"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.41","doi-asserted-by":"publisher","DOI":"10.1016\/j.jemermed.2005.08.020"},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.42","unstructured":"Ramrakha P Moore K . Oxford handbook of acute medicine. 2nd Edn. New York: Oxford University Press, 2004:392\u20133."},{"key":"2025082800202894000_2014.jun06_1.bcr2014204732.43","doi-asserted-by":"publisher","DOI":"10.1111\/j.1399-6576.2007.01289.x"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2014-204732","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T07:20:40Z","timestamp":1756365640000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2014-204732"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,6,6]]},"references-count":43,"alternative-id":["10.1136\/bcr-2014-204732"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2014-204732","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,6,6]]}}}