@article{ref1,
title="Intoxication with cardiovascular drugs",
journal="Kardiologe",
year="2012",
author="Trappe, H.-j.",
volume="6",
number="6",
pages="484-494",
abstract="BACKGROUND: In 60-70% of intoxications (Int) in adults, the purpose of drug administration is a suicide attempt. In 15-25% of patients, drug ingestion is accidental and in 5% commercial. Among all toxic agents, pharmaceutical drugs are responsible for Int in 80-90% of patients. Most frequent drugs for Int are psychotropic drugs or hypnotics. Cardiovascular drugs are rarely the cause for Int, but digitalis (dig) and betablocking (BB) intoxications are known. Diagnosis: In patients with Int, history, physical examination and the 12-lead surface ECG are essential because most Int due to cardiovascular drugs lead to supraventricular or ventricular arrhythmias. Dig Int leads most frequently to atrioventricular conduction disturbances (AV-blocks), BB Int leads to sinuatrial or AV nodal conduction disturbances, bradycardia and hypotonia. Calcium antagonist Int is associated with AV-conduction disturbances or cardiac arrest. QT prolongation and torsade de pointes tachycardia are greatly feared when class I and III antiarrhythmic drugs were used. Salicylate Int is mostly associated with central nervous system disturbances. Therapy: It is necessary to treat all Int patients in the intensive care unit. In AV conduction disturbances atropine or temporary pacemaker stimulation is recommended. Patients with dig Int should be given a dig antidote, while patients with AD and torsade de pointes tachycardia and/or ventricular fibrillation need direct current cardioversion/defibrillation. Hemodialysis is necessary in severe salicylate Int. © 2012 Springer-Verlag Berlin Heidelberg.<p /><p>Language: de</p>",
language="de",
issn="1864-9726",
doi="10.1007/s12181-012-0461-4",
url="http://dx.doi.org/10.1007/s12181-012-0461-4"
}