ABSTRACT

Objective:

Calcium channel blockers (CCBs) are used in the treatment of angina, hypertension, arrhythmias, and prevention of migraines. The incidence of accidental or intentional calcium channel blocker intoxication has increased in recent years, which is thought to be related to more frequent use. Calcium channel blockers intoxications may progress to mortality. In our study, we investigated the treatments of suicidal or accidental calcium channel blocker intoxications and the relationships between the complications and these therapies.

Material and Methods:

The data of this retrospective study were obtained from the patient files. The patients who had been admitted to the Konya Training and Research Hospital with excessive intake of calcium channel blockers and been followed-up in the toxicology and emergency critical intensive care units between 2010 and 2012 were sequentially included in the study. No cases were excluded from the study.

Results:

A total of 15 patients were included in the study. Eight patients had taken verapamil, 4 patients had taken amlodipine, and 3 patients had taken nifedipine. The treatment included 0.9% normal saline infusion for all patients. Ten patients were given calcium replacement and 4 were given renal replacement therapy. ILE infusion was begun in six patients. Six patients were given glucagon. Five patients had developed hyperglycemia, 4 of whom underwent high-dose insulin-glucose treatment. Various complications were observed in 10 of the 15 cases. Hyperglycemia and non-cardiogenic pulmonary oedema were observed in 33.3% of the patients, metabolic acidosis was observed in 40% and block was observed in 26.7%. Cardiac arrest was observed in two patients, one of whom died.

Conclusion:

According to our results, none of the treatments had any priority over another. In order to prevent the possible complications, we suggest the application of multi-treatment strategies in the early period, particularly in high dose CCB intakes.