Verapamil intoxication: beware of the delayed effect

Intoxication with calcium channel inhibitory drugs is rare but mortality rates reach 10 %. We report the case of a 5-year-old girl who had ingested five 240-mg tablets of extended-release verapamil (VLP) and a tablet of bromazepam. Thirty hours after the ingestion she had a vasoplegic shock, heart c...

Full description

Saved in:
Bibliographic Details
Published inArchives de pédiatrie : organe officiel de la Société française de pédiatrie Vol. 21; no. 12; pp. 1344 - 1347
Main Authors Charpentier, C, Flandrois, M, Labombarda, F, Maragnes, P, Jokic, M, Villedieu, F
Format Journal Article
LanguageFrench
Published France 01.12.2014
Subjects
Calcium Channel Blockers - poisoning
Child, Preschool
Female
Humans
Poisoning - diagnosis
Poisoning - therapy
Time Factors
Verapamil - poisoning
Online AccessGet full text

Cover

More Information
Summary:Intoxication with calcium channel inhibitory drugs is rare but mortality rates reach 10 %. We report the case of a 5-year-old girl who had ingested five 240-mg tablets of extended-release verapamil (VLP) and a tablet of bromazepam. Thirty hours after the ingestion she had a vasoplegic shock, heart conduction disorders, and metabolic complications. She was treated in pediatric intensive care with continuous epinephrine and insulin and recovered completely 60h after the ingestion. This case underlines the danger of calcium channel blocker overdose, increased by the extended-release mechanism: the drug effect is to slow down gastric motility - which explains the latency of the symptoms - but this also increases the drug absorption, inducing a vicious circle. These mechanisms in calcium blocker intoxication need to be kept in mind in order to decrease the mortality of such accidents.
Bibliography:ObjectType-Article-2
SourceType-Scholarly Journals-1
ObjectType-Feature-1
content type line 23
ObjectType-Report-3
ObjectType-Case Study-4
ISSN:1769-664X
DOI:10.1016/j.arcped.2014.09.013