Prospective analysis of cardiovascular drug intoxication
Öz
Purpose: The aim of this study is to provide data about diagnosis, treatment, and results of the patients poisoned by drugs affecting the cardiovascular system.
Materials and Methods: Patients aged 18 and over who applied to the emergency department with drug poisoning affecting cardiovasculer system were included in the study. The demographic data, drugs and doses, emergency treatment and the time of development of shock or bradycardia, treatment, antidotes and invasive procedures were recorded.
Results: In our study twenty-five patients, 8 (32 %) male and 17 (68 %) female, were included. At the admission, 56 % (n=14) had hypotension, 8 % (n=2) had bradycardia, at the second hour 76 % (n=19) had hypotension, 16 % (n=4) had bradycardia. Within 6 hours after admission, 80 % (n=20) patients had hypotension, 28 % (n=7) patients had bradycardia at least once. Fifty-two percent (n=13) of the patients calcium, 36 % (n=9) glukagon, 32 % (n=8) lipid, 12 % (n=3) atropine, 20 % (n=5) positive inotropes were given.
Conclusion: Lipid therapy produces positive results in patients who did not improve with calcium, glucagon and fluid therapy. Patients who received calcium channel blockers experienced more cardiogenic shock and bradycardia was more common in patients receiving beta-blockers.
Anahtar Kelimeler
Cardiovascular drug poisoning, beta-blocker, poisoning, calcium channel blocker, lipid emulsion treatment, emergency
Kaynakça
- Chirasirisap K, Ussanawarong S, et al. A study of major causes and types of poisoning in Khonkaen, Thailand. Vet Hum Toxicol. 1992 Dec;34(6):489-92. PMID: 1287966.
- Neuvonen PJ, Kivistö DK, Elonen E, Laine DK, Olkkola KO. Acute poisonings: epidemiology and gastrointestinal decontamination. 2001:11-4 (http://ethesis.helsinki.fi).
- Hanssens Y, Deleu D, Taqi A. Etiologic and demographic characteristics of poisoning: a prospective hospital-based study in Oman. J Toxicol Clin Toxicol. 2001;39(4):371-80. doi: 10.1081/clt-100105158. PMID: 11527232.
- Özcan N, İkincioğulları D. Ulusal Zehir Danışma Merkezi 2008 Yılı Çalışma Raporu Özeti. Turk Hij Den Biyol Derg. 2009;66(ER-3):29-58 (https://www.turkhijyen.org/jvi.aspx?pdir=turkhijyen&plng=tur&un=THDBD-65807).
- Howarth DM, Dawson AH, Smith AJ, Buckley N, Whyte IM. Calcium channel blocking drug overdose: an Australian series. Hum Exp Toxicol. 1994 Mar;13(3):161-6. doi: 10.1177/096032719401300304. PMID: 7909677.
- Wax PM, Erdman AR, Chyka PA, et al. Beta-blocker ingestion: an evidence-based consensus guideline for out-of-hospital management. Clin Toxicol (Phila). 2005;43(3):131-46. PMID: 15906457.
- DeWitt CR, Waksman JC. Pharmacology, pathophysiology and management of calcium channel blocker and beta-blocker toxicity. Toxicol Rev. 2004;23(4):223-38. doi: 10.2165/00139709-200423040-00003. PMID: 15898828.
- Love JN, Elshami J. Cardiovascular depression resulting from atenolol intoxication. Eur J Emerg Med. 2002 Jun;9(2):111-4. doi: 10.1097/00063110-200206000-00002. PMID: 12131631.
- Janion M, Stepień A, Sielski J, Gutkowski W. Is the intra-aortic balloon pump a method of brain protection during cardiogenic shock after drug intoxication? J Emerg Med. 2010 Feb;38(2):162-7. doi: 10.1016/j.jemermed.2007.10.037. Epub 2008 Apr 9. PMID: 18403163.
- Love JN, Enlow B, Howell JM, Klein-Schwartz W, Litovitz TL. Electrocardiographic changes associated with beta-blocker toxicity. Ann Emerg Med. 2002 Dec;40(6):603-10. doi: 10.1067/mem.2002.129829. PMID: 12447337.
