{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,4]],"date-time":"2026-05-04T01:56:27Z","timestamp":1777859787121,"version":"3.51.4"},"reference-count":12,"publisher":"SAGE Publications","issue":"6","license":[{"start":{"date-parts":[[2022,7,21]],"date-time":"2022-07-21T00:00:00Z","timestamp":1658361600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Pharmacy Practice"],"published-print":{"date-parts":[[2023,12]]},"abstract":"\n Introduction<\/jats:title>\n Hyperinsulinemia-euglycemia therapy [HIE] is a first line therapy recommended in symptomatic calcium channel blocker overdose patients. HIE, particularly if administered in concentrations typically used for glycemic control, would result in a substantial amount of hypotonic fluid administration, which places patients at risk of volume overload. Therefore, it may be beneficial to utilize a concentrated insulin as a strategy to mitigate fluid overload risks. We report the case of a 73\u00a0years old, 69.9\u00a0kg female, who presented to the emergency department after an accidental ingestion of 70\u00a0mg amlodipine and was treated with HIE utilizing a uniquely concentrated insulin infusion.<\/jats:p>\n <\/jats:sec>\n \n Case Presentation<\/jats:title>\n HIE at 10\u00a0units\/kg\/hr. was used for approximately 17\u00a0hours. Insulin was changed from a 1\u00a0unit\/mL concentration to 16\u00a0unit\/mL. Dextrose 10% infusion was initiated up to a max of 650\u00a0mL\/hr. and norepinephrine infusion up to a max of 10\u00a0mcg\/min.<\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n Approximate fluid requirements from the 16\u00a0unit\/mL concentration of insulin totaled 1\u00a0L as compared to a 1\u00a0unit\/mL concentration which would have required 17\u00a0L, a total savings of 16\u00a0L. This savings potentially decreased the risk of cerebral or pulmonary edema associated with fluid overload.<\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Use of a concentrated insulin in the setting of a calcium channel blocker or beta blocker overdose provides a unique strategy to mitigate the effects associated with fluid overload.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/08971900221116189","type":"journal-article","created":{"date-parts":[[2022,7,21]],"date-time":"2022-07-21T11:45:37Z","timestamp":1658403937000},"page":"1519-1522","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":2,"title":["Use of Concentrated Insulin in the Management of Calcium Channel Blocker Overdose: A Case Report"],"prefix":"10.1177","volume":"36","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2811-0995","authenticated-orcid":false,"given":"Rachel","family":"Rafeq","sequence":"first","affiliation":[{"name":"Department of Emergency Medicine, Cooper University Hospital, Camden, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8277-4928","authenticated-orcid":false,"given":"Matthew","family":"Salzman","sequence":"additional","affiliation":[{"name":"Department of Emergency Medicine, Cooper University Hospital, Camden, NJ, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2022,7,21]]},"reference":[{"key":"bibr1-08971900221116189","doi-asserted-by":"publisher","DOI":"10.3109\/15563650.2011.582471"},{"key":"bibr2-08971900221116189","doi-asserted-by":"publisher","DOI":"10.1002\/phar.2177"},{"key":"bibr3-08971900221116189","doi-asserted-by":"publisher","DOI":"10.1097\/CCM.0000000000002087"},{"key":"bibr4-08971900221116189","doi-asserted-by":"publisher","DOI":"10.1007\/s13181-020-00758-8"},{"key":"bibr5-08971900221116189","doi-asserted-by":"publisher","DOI":"10.3109\/15563650.2013.770152"},{"key":"bibr6-08971900221116189","doi-asserted-by":"publisher","DOI":"10.1177\/1060028018810794"},{"key":"bibr7-08971900221116189","doi-asserted-by":"publisher","DOI":"10.1080\/15563650.2020.1725034"},{"key":"bibr8-08971900221116189","doi-asserted-by":"publisher","DOI":"10.1093\/ajhp\/zxab439"},{"key":"bibr9-08971900221116189","doi-asserted-by":"publisher","DOI":"10.3109\/15563650.2011.593522"},{"key":"bibr10-08971900221116189","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajem.2018.02.004"},{"key":"bibr11-08971900221116189","doi-asserted-by":"publisher","DOI":"10.1345\/aph.1C032"},{"key":"bibr12-08971900221116189","doi-asserted-by":"publisher","DOI":"10.1080\/15563650.2016.1209766"}],"container-title":["Journal of Pharmacy Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08971900221116189","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/08971900221116189","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/08971900221116189","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T00:37:40Z","timestamp":1777509460000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/08971900221116189"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,7,21]]},"references-count":12,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2023,12]]}},"alternative-id":["10.1177\/08971900221116189"],"URL":"https:\/\/doi.org\/10.1177\/08971900221116189","relation":{},"ISSN":["0897-1900","1531-1937"],"issn-type":[{"value":"0897-1900","type":"print"},{"value":"1531-1937","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,7,21]]}}}