RESUMEN
While relatively uncommon, an overdose of calcium channel blockers, beta blockers, or digoxin can result in significant morbidity and mortality, and management can be complex. An acute overdose will require different management strategies than chronic toxicity while on therapeutic dosing. Toxicity from these agents must be considered in bradycardic and hypotensive patients. This supplement provides an evidence-based overview of emergency department management of calcium channel blocker overdose, beta blocker overdose, and digoxin toxicity, and focuses on the caveats of treatment for each.
Asunto(s)
Antagonistas Adrenérgicos beta/envenenamiento , Bloqueadores de los Canales de Calcio/envenenamiento , Digoxina/envenenamiento , Sobredosis de Droga/diagnóstico , Sobredosis de Droga/terapia , Apoyo Vital Cardíaco Avanzado , Diagnóstico Diferencial , Servicio de Urgencia en Hospital , Medicina Basada en la Evidencia , HumanosAsunto(s)
Dolor Abdominal/etiología , Anemia Hipocrómica/etiología , Contaminación de Medicamentos , Intoxicación por Plomo/diagnóstico , Plomo/análisis , Adicción al Opio/complicaciones , Opio/química , Adulto , Anorexia/etiología , Diagnóstico Diferencial , Eritrocitos/patología , Fatiga/etiología , Pruebas Hematológicas , Humanos , Plomo/sangre , Intoxicación por Plomo/complicaciones , Masculino , Porfirias/diagnóstico , Convulsiones/etiologíaRESUMEN
Single-patient methanol intoxications are a common clinical presentation, but outbreaks are rare and usually occur in settings in which there is limited access to ethanol and methanol is consumed as a substitute. In this case report, we describe an outbreak of methanol intoxications that was challenging from a public health perspective and discuss strategies for managing such an outbreak.
Asunto(s)
Acidosis/epidemiología , Brotes de Enfermedades , Metanol/envenenamiento , Intoxicación/epidemiología , Solventes/envenenamiento , Equilibrio Ácido-Base , Acidosis/inducido químicamente , Acidosis/terapia , Adulto , Antídotos/uso terapéutico , Ingestión de Alimentos , Fomepizol , Humanos , Fracking Hidráulico , Leucovorina/uso terapéutico , Masculino , Manitoba/epidemiología , Persona de Mediana Edad , Náusea/inducido químicamente , Náusea/epidemiología , Intoxicación/terapia , Pirazoles/uso terapéutico , Diálisis Renal , Bicarbonato de Sodio/uso terapéutico , Vómitos/inducido químicamente , Vómitos/epidemiología , Adulto JovenRESUMEN
While it is relatively uncommon, an overdose of calcium-channel blockers, beta blockers, or digoxin has a significant morbidity and mortality rate, and its management can be complex. Digoxin toxicity can present with an acute overdose or as chronic toxicity while a patient is on therapeutic dosing, which has implications for diagnosis and management. While the patient's specific clinical presentation may depend on factors such as the time of exposure and the type of agent ingested, the differential diagnosis of the bradycardic and hypotensive patient is narrow, and toxicity from these agents must be considered. This review provides an evidence-based overview of the emergency department management of calcium-channel blocker overdose, beta blocker overdose, and digoxin toxicity.
