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Overdose of sustained-release verapamil
P M Barrow1, P L Houston, D T Wong
1Department of Anaesthesia and Intensive Care, Toronto Hospital, Ontario, Canada.
British Journal of Anaesthesia
|March 1, 1994
Summary
Verapamil toxicity can cause severe heart problems, and sustained-release versions may lead to delayed, prolonged effects. Prompt gastrointestinal decontamination can prevent serious verapamil poisoning outcomes.
Area of Science:
- Cardiology
- Clinical Toxicology
- Pharmacology
Background:
- Verapamil is a calcium channel blocker used for cardiovascular conditions.
- Verapamil toxicity presents with hypotension, myocardial depression, and cardiac conduction disturbances.
- No specific antidote exists for verapamil poisoning, necessitating supportive care.
Observation:
- This report details two cases of severe verapamil poisoning from sustained-release formulations.
- One patient experienced prolonged hypotension and third-degree heart block for 48 hours.
- The second patient avoided significant toxicity through effective gastrointestinal decontamination.
Findings:
- Sustained-release verapamil overdose can cause delayed and prolonged toxicity.
- Aggressive gastrointestinal decontamination is crucial in managing verapamil overdose.
- Supportive care remains the cornerstone of verapamil poisoning management.
Implications:
- Early and effective gastrointestinal decontamination can mitigate severe verapamil toxicity.
- Understanding the prolonged effects of sustained-release verapamil is vital for patient management.
- This highlights the importance of prompt medical intervention in calcium channel blocker overdose.