A ONE-YEAR EVALUATION OF CALCIUM-CHANNEL BLOCKER OVERDOSES - TOXICITY AND TREATMENT

被引：105

作者：

RAMOSKA, EA

SPILLER, HA

WINTER, M

BORYS, D

机构：

[1] Division of Emergency Medicine, Thomas Jefferson University Hospital, Philadelphia, PA

[2] Delaware Valley Regional Poison Control Center, Philadelphia, PA

[3] Texas State Poison Center, Galveston

[4] Hennepin Regional Poison Center, Minneapolis, MN

来源：

ANNALS OF EMERGENCY MEDICINE | 1993年 / 22卷 / 02期

关键词：

CALCIUM CHANNEL BLOCKER;

D O I：

10.1016/S0196-0644(05)80202-1

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Study objective: To examine the cardiovascular toxicity of calcium channel blockers and the efficacy of various treatments. Design: Case series collected prospectively over one year. Setting: Three regional poison control centers. Type of participants: One hundred thirty-nine hospitalized patients who had ingested a calcium channel blocker. Interventions: Calcium, dopamine, atropine, isoproterenol, glucagon, and pacemakers. Main results: Hypotension, sinus node suppression, and dysrhythmias often occur with calcium channel blocker overdoses, but atrioventricular nodal block occurs more often with verapamil (chi2 test, P<.025). Calcium was administered to 23 patients and was efficacious in reversing depression of cardiac conduction and increasing blood pressure. Dopamine was administered to ten patients and was efficacious in increasing blood pressure. Atropine was administered to eight patients, but only two had a positive response. Conclusion: Atrioventricular nodal depression is more common with verapamil overdoses. Calcium and dopamine are useful in treating toxicity from calcium channel blocker overdose, whereas atropine is sometimes useful.

引用

页码：196 / 200

页数：5

共 7 条

[1]

Merz, Pharmaceutical list tracks hit parade of prescriptions, American Medical News, (1991)

[2]

Veltri, Litovitz, 1983 annual report of the American Association of Poison Control Centers national data collection system, The American Journal of Emergency Medicine, 2, pp. 240-443, (1984)

[3]

Litovitz, Bailey, Schmitz, Et al., 1990 annual report of the American Association of Poison Control Centers national data collection system, Am J Emerg Med, 9, pp. 461-509, (1991)

[4]

Ramoska, Spiller, Myers, Calcium channel blocker toxicity, Ann Emerg Med, 19, pp. 649-653, (1990)

[5]

Henry, Comparative pharmacology of calcium antagonists: Nifedipine, verapamil, and diltiazem, Am J Cardiol, 46, pp. 1047-1058, (1980)

[6]

Millard, Lathrop, Grupp, Et al., Differential cardiovascular effects of calcium channel blocking agents: Potential mechanisms, Am J Cardiol, 49, pp. 499-506, (1982)

[7]

Zarltsky, Horowitz, Chernow, Glucagon antagonism of calcium channel blocker-induced myocardial dysfunction, Critical Care Medicine, 16, pp. 246-251, (1988)

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