Patients with trivial ingestions (<3 mg/kg of a first-generation dihydropyridine, <0.2 mg/kg of a second-generation dihydropyridine, or <5 mg/kg of diltiazem or verapamil), a normal heart rate and blood pressure, and no symptoms can be observed for approximately 6 h and discharged. Patients who report a large overdose of a sustained-release preparation (>10 mg/kg of verapamil or diltiazem) or a dihydropyridine derivative with a half-life over 12 h ( IabJ.e17.0i3) should be admitted for ECG monitoring for at least 12 h, even if they exhibit no symptoms. All patients with signs and symptoms of CCB toxicity should be admitted to an appropriate setting. Any patient who requires inotropic support (including bolus doses of calcium salts) should be admitted to an intensive care unit.
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