[Acute diltiazem poisoning: kinetic and hemodynamics study]
A Jaeger1, P Sauder, G Bianchetti
1Service de Réanimation médicale et Centre Anti-Poisons, Pav. Pasteur, C.H.U., Strasbourg.
Diltiazem overdose can cause hypotension and heart conduction issues. Prompt treatment with activated charcoal and vasopressors led to full recovery in three patients.
Area of Science:
- Cardiology
- Clinical Pharmacology
Background:
- Diltiazem is a calcium channel blocker used for cardiovascular conditions.
- Overdose can lead to significant hemodynamic and electrophysiologic disturbances.
Observation:
- Three cases of diltiazem overdose presented with hypotension and atrio-ventricular conduction disturbances.
- Hemodynamic studies revealed a hyperkinetic state with reduced systemic vascular resistance.
Findings:
- Diltiazem plasma half-life ranged from 5.4 to 8.3 hours.
- Prolonged absorption was observed up to 28 hours in one case.
- Treatment involved gastric lavage, activated charcoal, plasma expanders, and alpha-agonist vasopressors.
Implications:
- Early recognition and management of diltiazem overdose are crucial.
- Hemodynamic monitoring and supportive care are essential for patient recovery.
- Understanding diltiazem's pharmacokinetic profile aids in managing overdose toxicity.
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