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Management in Calcium Channel Blocker Overdose Patients Reported to Ramathibodi Poison Center |
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| รหัสดีโอไอ | |
| Creator | Sirasa Ruangritchankul |
| Title | Management in Calcium Channel Blocker Overdose Patients Reported to Ramathibodi Poison Center |
| Contributor | Winai Wananukul, Sahaphume Srisuma |
| Publisher | Faculty of Pharmaceutical Sciences KKU MSU UBU |
| Publication Year | 2561 |
| Journal Title | Isan Journal of Pharmaceutical Sciences |
| Journal Vol. | 14 |
| Journal No. | 2 |
| Page no. | 70-82 |
| Keyword | management, calcium channel blocker, overdose |
| URL Website | https://tci-thaijo.org/index.php/IJPS |
| Website title | Isan Journal ofPharmaceutical Sciences, IJPS |
| ISSN | 19050852 |
| Abstract | Besides supportive care, specific managements of severe calcium channel blocker (CCB) overdose are varied, including calcium, high-dose insulin euglycemic therapy (HIE), and high-dose vasopressor. The objective of this study is to describe management and outcome of CCB poisoning in Thailand. Methods. This is a retrospective study of CCB poisoning cases consulted to Ramathibodi Poison Center, during 2012 to 2016. Results. One-hundred and forty-five CCB poisoning cases were retrieved. Most common scenario was intentional amlodipine ingestion. Common manifestations were hypotension and tachyarrhythmia. In 30 cases with severe poisoning, the prescribed specific treatment included, IV calcium (76.7%), high-dose vasopressor (33.3%), HIE (16.7%), glucagon (10.0%), and lipid emulsion (6.7%). There were 6 deaths. Two cases received usual maximum dose of vasopressor without further titration. One was treated with IV insulin drip 1 u/kg/h and usual dose of vasopressor without further titration of insulin and vasopressor. One got delayed increasing dose of vasopressor more than 12 hours. One had cardiac arrest from rebound hyperkalemia while decrease HIE. One was recovered from poisoning, but later died from pneumonia. Conclusion. Common prescribed specific treatments were IV calcium, high-dose vasopressor, and HIE. Unfamiliar and underused of high-dose vasopressor and HIE may related to worse outcome. |
