TY  - JOUR
PY  - 2009//
TI  - Surprisingly delayed escalation of severe verapamil poisoning
JO  - European journal of emergency medicine
A1  - Tuka, Vladimir
A1  - Ricarova, Bronislava
A1  - Janota, Tomas
A1  - Malik, Jan
A1  - Kotrlikova, Eva
SP  - 100
EP  - 102
VL  - 16
IS  - 2
N2  - We present a case report of intoxication by a potentially lethal dose of sustained-release verapamil with delayed escalation of complications. The patient was hospitalized 1.5 h after an attempted suicide with a very high dose of verapamil sustained-release (7.2 g). On admission the plasma concentrations were extremely high (3600 ng/l). Heart rate and blood pressure declined slowly with a surprising sudden escalation on the third day coupled with hemodynamic collapse and loss of consciousness. Complete recovery was achieved in spite of 2 h of extreme hypotension. We outline the clinical course, a need for massive bowel irrigation in case of sustained-release medication, the timing of a temporary pacing and the effect of centralization of circulation even on invasively measured blood pressure.<p /> <p>Language: en</p>
LA  - en
SN  - 0969-9546
UR  - http://dx.doi.org/10.1097/MEJ.0b013e32830a997c
ID  - ref1
ER  -