For a patient presenting with sinus bradycardia after an overdose of extended-release diltiazem, what is the recommended treatment?

In the scenario of a patient experiencing sinus bradycardia due to an overdose of extended-release diltiazem, the appropriate course of action involves addressing the cardiovascular effects of the calcium channel blocker overdose. Diltiazem can lead to bradycardia due to its action on the cardiac nodes, and therefore, immediate measures to restore heart rate and support cardiac function are warranted.

Insulin and dextrose administration can be beneficial in calcium channel blocker overdose cases because insulin helps to enhance myocardial contractility and can facilitate the metabolism of glucose into energy, potentially improving myocardial function. This treatment is particularly useful in cases of severe toxicity, as it can mitigate the bradycardia and support cardiovascular stability.

In contrast, other treatments like atropine administration may have diminished effectiveness in the context of diltiazem overdose due to the underlying mechanisms of the drug's action. Temporary pacing may be necessary in severe and persistent cases where pharmacologic interventions fail to restore an adequate heart rate or stabilize hemodynamics, but it is typically considered after other measures. Meanwhile, aminophylline is not a first-line treatment for bradycardia due to diltiazem toxicity.

In summary, using insulin and dextrose can support cardiac function and is aligned