Insulin-glucose as adjunctive therapy for severe calcium channel antagonist poisoning

被引:127
作者
Yuan, TH [1 ]
Kerns, WP [1 ]
Tomaszewski, CA [1 ]
Ford, MD [1 ]
Kline, JA [1 ]
机构
[1] Carolinas Med Ctr, Dept Emergency Med, Charlotte, NC 28232 USA
来源
JOURNAL OF TOXICOLOGY-CLINICAL TOXICOLOGY | 1999年 / 37卷 / 04期
关键词
D O I
10.1081/CLT-100102437
中图分类号
R99 [毒物学(毒理学)];
学科分类号
100405 ;
摘要
Case Report: This case series documents the clinical courses of 4 patients after verapamil overdose and 1 patient after amlodipine-atenolol overdose. All subjects had hypodynamic circulatory shock (hypotension, bradycardia, and acidosis) that was not adequately responsive to conventional treatment. After initiation of insulin-dextrose infusion, the hemodynamic status of all 5 patients stabilized and all patients survived, Plasma drug concentrations are reported for all cases and verapamil levels were extremely high in 2 patients (3710 ng/mL and 3980 ng/mL), However, because patients were not treated according to a standard protocol, each patient received variable other supportive measures and inotropic agents, and the infusion rates of insulin were variable among patients. This report provides preliminary evidence toward a larger trial of insulin-dextrose to treat hypodynamic shock from calcium channel blocker overdose.
引用
收藏
页码:463 / 474
页数:12
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