[The clinical implications in patients after calcium channel blockers overdose--own observations]

Calcium channel blockers are drugs often used in circulatory system diseases. Their overdose can cause asystoly, III grade of atrioventricular dissociation, heart insufficiency and cardiogenic shock. Due to wide availability of these drugs access to them for subjects who want commit suicide is easy. In a specialist literature predominantly you can find case reports about calcium channel blockers suicidal overdose. Our experience includes 12 such cases. The aim of the study was to analyze patients after suicidal calcium channel blockers overdose.

In all cases medical interview, physical examination, neurological consultation, ecg, echocardiography, laboratory tests and in most cases--gasometry and toxicology test were performed.

In analyzed 12 subjects group during admission, 7 patients were conscious, 2 had consciousness disturbances and 3 subjects were unconscious. Due to significant hypotonia 10 patients were treated with pressive amines. Arrhythmia and conduction disturbances were treated with endocavitary heart stimulation. There were 2 patients who needed mechanical respiratory support and one person, who due to refractory on farmacologic treatment, cardiogenic shock - needed intra aortal balloon pumping assistance. One person died during the first day of hospitalization. All other patients were discharged from the ward with improvement.

Calcium channel blockers intoxications are rare, but usually are characterized by serious course and uncertain prognosis. Temporary endocavitary heart stimulation during calcium channel blockers intoxication usually needs electrode repositions due to ineffective stimulation depending on stimulation threshold increase. Our results show, that extremely fundamental for intoxicated patient are, easy to perform, activities which limit gastro-intestinal drug absorbtion.