What pathway leads to insulin resistance in calcium channel blocker overdose?
Calcium channel blockers cause dysregulation of the phosphoinositide 3-kinase pathway for glucose entry by inhibiting protein kinase B, resulting in insulin resistance and need for high doses of insulin (1-10 units/kg/hr) to treat myocardial depression.
Bechtel LK, Haverstick DM, Holstege CP. Verapamil toxicity dysregulates the phosphatidylinositol 3-kinase pathway. Acad Emerg Med. 2008 Apr;15(4):368-74. doi: 10.1111/j.1553-2712.2008.00088.x. PMID: 18370992.
Contributed by: Emily Plasencia, PharmD on behalf of the Acute & Intensive Care