Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 1 de 1
Filtrar
Más filtros












Base de datos
Intervalo de año de publicación
1.
Cardiovasc Toxicol ; 22(1): 63-66, 2022 01.
Artículo en Inglés | MEDLINE | ID: mdl-34643856

RESUMEN

Intoxication from calcium channel blockers exhibits almost 50% mortality rates. Amlodipine is a long-acting dihydropyridine and inappropriate dosage poses a great threat for profound vasodilation, hypotension, and refractory vasopressor-resistant shock. A 72-year-old woman with unremarkable medical history presented to the emergency department due to amlodipine overdose after a suicide attempt attributed to COVID-19 pandemic severe anxiety disorder. Vital signs at presentation: heart rate 82 beats/ min, arterial pressure 72/55 mmHg, and oxygen saturation 98%. Resuscitation was initiated with intravenous infusion of normal saline 0,9%, noradrenaline, and calcium chloride, while activated charcoal was orally administrated; however, blood pressure remained at 70/45 mmHg. Abruptly, she experienced acute pulmonary edema and was finally intubated. We commenced high-dose insulin infusion with Dextrose 10% infusion to maintain euglycemic hyperinsulinemia. Hemodynamic improvement occurred after 30 min, systolic blood pressure raised to 95 mmHg, and decongestion was achieved with intravenous furosemide. Insulin effect was dose-dependent and patient's hemodynamic status improved after insulin uptitration. Eight days later, the patient was weaned from the mechanical ventilation and she was successfully discharged after 14 days. High-dose intravenous infusion of insulin up to 10 units/kg per hour appears as an inotropic agent possibly through alterations in myocardial metabolism of fatty acids and augmentation of insulin secretion and uptake. This regimen possibly exhibits additional vasotropic properties. We conclude that euglycemic hyperinsulinemia is a potentially advantageous treatment in CCB toxicity.


Asunto(s)
Amlodipino/toxicidad , COVID-19 , Sobredosis de Droga/tratamiento farmacológico , Hiperinsulinismo/inducido químicamente , Choque/tratamiento farmacológico , Intento de Suicidio , Anciano , COVID-19/psicología , Bloqueadores de los Canales de Calcio/toxicidad , Sobredosis de Droga/sangre , Sobredosis de Droga/diagnóstico , Femenino , Humanos , Hiperinsulinismo/sangre , Insulina/administración & dosificación , Choque/sangre , Choque/diagnóstico , Intento de Suicidio/psicología
SELECCIÓN DE REFERENCIAS
DETALLE DE LA BÚSQUEDA
...