Kalsiyum Kanal Blokeri Zehirlenmeleri

Year 2022, Volume: 5 Issue: 2, 92 - 98, 30.06.2022

Ayça Açıkalın Ömer Taşkın Rana Dişel

https://doi.org/10.54996/anatolianjem.1070910

Cited By: 1

Abstract

Kalsiyum kanal blokerleri toplumda çok yaygın olarak kullanılan bir kardiyovasküler ilaç gurubudur. Sık reçete edilmesi, kolay ulaşılabilir olması nedeniyle özkıyım amacıyla yüksek doz alımlarına acil servislerde sıklıkla rastlanılmaktadır. Aşırı doz alımları dirençli şok, hayatı tehdit eden bradidisritmi, kardiyojenik şok, çoklu organ yetmezliği nedeniyle ölüme sebebiyet verebilir. Erken tanı ve erken tedavi hayati önem arzeder. Bu ilaçlar dirençli şok yapıcı etkileri nedeniyle ölüme sebebiyet verebilseler de etkin antidotları ve güncel tedavi yöntemleriyle de başarıyla tedavi edilebilmektedir. Bu derleme de güncel literatür eşliğinde KKB zehirlenmelerine kapsamlı bir şekilde değinilmiştir.

Keywords

Kalsiyum kanal blokerleri, lipid, şok, zehirlenme

Calcium Channel Blockers Intoxications

Abstract

Calcium channel blockers are a group of cardiovascular drugs that used very common in society. Since doctors frequently prescribed them and are easily accessible, it is very common to encounter in the emergency departments with overdose to aim suicide. The overdose of these drugs causes mortality by resistant shock, mortal bradyarrhythmia, cardiogenic shock and multiple organ failure. It is vital to diagnose and treat early. Even though these drugs cause mortality by resistant shock, it can be successfully treatable with effective antidotes and current treatment methods. In this review, we aim to discuss CCBs poisonings widely with current literature.

Keywords

Calcium channel blockers, lipid, shock, poisoning

References

• Christensen MB, Petersen KM, Bøgevig S, et al. Outcomes following calcium channel blocker exposures reported to a poison information center. BMC pharmacology & toxicology [Internet]. 2018 Nov 27 [cited 2022 Feb 9];19(1). Available from: https://pubmed.ncbi.nlm.nih.gov/30482251/
• Watson WA, Litovitz TL, Rodgers GC, et al. 2002 annual report of the American Association of Poison Control Centers Toxic Exposure Surveillance System. The American journal of emergency medicine [Internet]. 2003 [cited 2022 Feb 9];21(5):353–421. Available from: https://pubmed.ncbi.nlm.nih.gov/14523881/
• Calcium channel blocker poisoning - UpToDate [Internet]. [cited 2022 Feb 9]. Available from: https://www.uptodate.com/contents/calcium-channel-blocker-poisoning
• DeRoos F. Calcium channel blockers. In: Goldfrank’s Toxicologic Emergencies. 8th ed. New York; 2006.
• Scholz H. Pharmacological aspects of calcium channel blockers. Cardiovascular drugs and therapy [Internet]. 1997 [cited 2022 Feb 9];10 Suppl 3(SUPPL. 3):869–72. Available from: https://pubmed.ncbi.nlm.nih.gov/9126675/
• Açıkalın A. Kalsiyum Kanal Blokerleri. In: Satar S, editor. Klinik toksikoloji tanı ve tedavi rehberi. Adana: Çukurova Nobel Tıp Kitabevi; p. 171–7.
• Wong A, Hoffman RS, Walsh SJ, et al. Extracorporeal treatment for calcium channel blocker poisoning: systematic review and recommendations from the EXTRIP workgroup. Clinical toxicology (Philadelphia, Pa) [Internet]. 2021 [cited 2022 Feb 9];59(5):361–75. Available from: https://pubmed.ncbi.nlm.nih.gov/33555964/
• Graudins A, Lee HM, Druda D. Calcium channel antagonist and beta-blocker overdose: antidotes and adjunct therapies. British journal of clinical pharmacology [Internet]. 2016 Mar 1 [cited 2022 Feb 9];81(3):453–61. Available from: https://pubmed.ncbi.nlm.nih.gov/26344579/
• Shepherd G. Treatment of poisoning caused by beta-adrenergic and calcium-channel blockers. American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists [Internet]. 2006 Oct 1 [cited 2022 Feb 9];63(19):1828–35. Available from: https://pubmed.ncbi.nlm.nih.gov/16990629/
• St-Onge M, Dubé PA, Gosselin S, et al. Treatment for calcium channel blocker poisoning: A systematic review. Clinical Toxicology (Philadelphia, Pa) [Internet]. 2014 Nov 1 [cited 2022 Feb 9];52(9):926. Available from: /pmc/articles/PMC4245158/
• Calcium Channel Blockers | Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 9e | AccessMedicine | McGraw Hill Medical [Internet]. [cited 2022 Feb 9]. Available from: https://accessmedicine.mhmedical.com/content.aspx?bookid=2353&sectionid=220745408
• Levine M, Boyer EW, Pozner CN, et al. Assessment of hyperglycemia after calcium channel blocker overdoses involving diltiazem or verapamil. Critical care medicine [Internet]. 2007 Sep [cited 2022 Feb 9];35(9):2071–5. Available from: https://pubmed.ncbi.nlm.nih.gov/17855820/
• St-Onge M, Anseeuw K, Cantrell FL, et al. Experts Consensus Recommendations for the Management of Calcium Channel Blocker Poisoning in Adults. Critical care medicine [Internet]. 2017 Mar 1 [cited 2022 Feb 9];45(3):e306–15. Available from: https://pubmed.ncbi.nlm.nih.gov/27749343/
• Proano L, Chiang WK, Wang RY. Calcium channel blocker overdose. The American journal of emergency medicine [Internet]. 1995 [cited 2022 Feb 9];13(4):444–50. Available from: https://pubmed.ncbi.nlm.nih.gov/7605536/
• Salhanick SD, Shannon MW. Management of calcium channel antagonist overdose. Drug safety [Internet]. 2003 [cited 2022 Feb 9];26(2):65–79. Available from: https://pubmed.ncbi.nlm.nih.gov/12534324/
• Kerns W, Kline J, Ford MD. Beta-blocker and calcium channel blocker toxicity. Emergency medicine clinics of North America. 1994 May;12(2):365–90.
• Elenhorn J.M, Schonwald S, Ordog G, et al. Elenhorn’s medical toxicology. Second Edition. 532–540 p.
• Thanacoody R, Caravati EM, Troutman B, et al. Position paper update: whole bowel irrigation for gastrointestinal decontamination of overdose patients. Clinical toxicology (Philadelphia, Pa) [Internet]. 2015 Jan 1 [cited 2022 Feb 9];53(1):5–12. Available from: https://pubmed.ncbi.nlm.nih.gov/25511637/
• Ashraf M, Chaudhary K, Nelson J, et al. Massive overdose of sustained-release verapamil: a case report and review of literature. The American journal of the medical sciences. 1995 Dec;310(6):258–63.
• Ehring T, Heusch G. Dihydropyridine calcium antagonists: beneficial or adverse effects in the setting of myocardial ischaemia/reperfusion? Cardiology [Internet]. 1997 Jan 1 [cited 2022 Feb 9];88 Suppl 1:3–14. Available from: https://pubmed.ncbi.nlm.nih.gov/9118166/
• Magdalan J, Kochman K, Antończyk A, et al. [Successful treatment by 4--aminopyridine of three cases of severe verapamil poisoning]. Przeglad lekarski. 2003;60(4):271–3.
• Report C, Welch CD, Knoerzer RE, et al. THE JOURNAL OF EXTRA-CORPOREAL TECHNOLOGY Verapamil and Acebutolol Overdose Results in Asystole: Intra-Aortic Balloon Pump Provides Mechanical Support.
• Vignesh C, Kumar M, Venkataraman R, et al. Extracorporeal Membrane Oxygenation in Drug Overdose: A Clinical Case Series. Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine [Internet]. 2018 Feb 1 [cited 2022 Feb 9];22(2):111. Available from: /pmc/articles/PMC5842452/
• Durward A, Guerguerian AM, Lefebvre M, et al. Massive diltiazem overdose treated with extracorporeal membrane oxygenation. Pediatric critical care medicine : a journal of the Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies [Internet]. 2003 [cited 2022 Feb 9];4(3):372–6. Available from: https://pubmed.ncbi.nlm.nih.gov/12831424/
• Babatasi G, Massetti M, Verrier V, et al. [Severe intoxication with cardiotoxic drugs: value of emergency percutaneous cardiocirculatory assistance]. Archives des maladies du coeur et des vaisseaux. 2001 Dec;94(12):1386–92.
• Engebretsen KM, Kaczmarek KM, Morgan J, et al. High-dose insulin therapy in beta-blocker and calcium channel-blocker poisoning. Clinical toxicology (Philadelphia, Pa). 2011 Apr;49(4):277–83. Referans27 Fadhlillah F, Patil S. Pharmacological and mechanical management of calcium channel blocker toxicity. BMJ case reports. 2018 Aug 27;2018.
• Fadhlillah F, Patil S. Pharmacological and mechanical management of calcium channel blocker toxicity. BMJ case reports. 2018 Aug 27;2018.
• Sin JH, Tom A, Toyoda A, et al. High-dose intravenous lipid emulsion affecting successful initiation of continuous venovenous hemofiltration and extracorporeal membrane oxygenation. Clinical toxicology (Philadelphia, Pa). 2018;56(2):149–50.
• Bania TC, Chu J, Perez E, et al. Hemodynamic effects of intravenous fat emulsion in an animal model of severe verapamil toxicity resuscitated with atropine, calcium, and saline. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine. 2007 Feb;14(2):105–11.
• Young AC, Velez LI, Kleinschmidt KC. Intravenous fat emulsion therapy for intentional sustained-release verapamil overdose. Resuscitation. 2009 May;80(5):591–3.
• Weinberg GL, Riou B. Lipid Emulsion Infusion. Anesthesiology. 2012 Jul 1;117(1):180–7.
• Sebe A, Dişel NR, Açıkalın Akpınar A, et al. Role of intravenous lipid emulsions in the management of calcium channel blocker and β-blocker overdose: 3 years experience of a university hospital. Postgraduate Medicine. 2015 Mar 4;127(2):119–24.
• Pichon N, Dugard A, Clavel M, et al. Extracorporeal albumin dialysis in three cases of acute calcium channel blocker poisoning with life-threatening refractory cardiogenic shock. Annals of emergency medicine. 2012 Jun;59(6):540–4.