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Related Experiment Videos

[Attempted suicide with sustained release diltiazem].

R Quispel1, H J Baur

  • 1Medisch Centrum Haaglanden, locative Westeinde, afd. Intensive Care, Den Haag.

Nederlands Tijdschrift Voor Geneeskunde
|June 5, 2001
PubMed
Summary

A 15-year-old experienced severe complications from diltiazem overdose, including hypotension, metabolic acidosis, and acute respiratory distress syndrome (ARDS). This case highlights the critical risks associated with sustained-release diltiazem intoxication.

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Area of Science:

  • Cardiology
  • Clinical Toxicology
  • Pharmacology

Background:

  • Diltiazem, a calcium channel blocker, is commonly prescribed for cardiovascular conditions.
  • Sustained-release formulations aim for prolonged therapeutic effect but may pose risks in overdose scenarios.
  • Intentional self-intoxication is a serious concern, particularly in adolescents.

Observation:

  • A 15-year-old presented with severe hypotension and oliguria following ingestion of 2000 mg of sustained-release diltiazem.
  • The patient developed metabolic acidosis with a peak plasma lactate of 10 mmol/l.
  • Adult respiratory distress syndrome (ARDS) necessitated mechanical ventilation for three days.

Findings:

  • Plasma diltiazem levels reached 500 µg/l, correlating with severe clinical manifestations.

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  • The case represents a rare but serious instance of diltiazem-induced ARDS.
  • Recovery was achieved after five days of intensive care unit management.

    • Implications:

    • This case underscores the potential for life-threatening toxicity with sustained-release diltiazem overdose.
    • Enhanced monitoring and management protocols are crucial for patients with significant diltiazem ingestion.
    • Understanding the pharmacokinetics and pharmacodynamics of diltiazem in overdose is vital for clinical toxicology.