Verapamil overdose
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Reactions 1477, p33 - 9 Nov 2013 O S Verapamil overdose Bowel necrosis: case report A 41-year-old woman developed delayed bowel necrosis after administering an intentional overdose of verapamil [Calan-SR]. The woman presented 2 hours after ingesting 30 × verapamil 240mg tablets. Activated charcoal and calcium gluconate were initiated; she was moved to the ICU. Normal vital signs were noted until 14 hours post-ingestion. The first sign of toxicity was bradycardia with a HR in the 40s; hypotension ensued followed by complete heart block and obtundation. She was intubated; hyperinsulin-euglyemia therapy, transvenous pacer implantation, haemodialysis, and lipid emulsion therapy, for 48 hours, were necessitated. Haemodynamic recovery was noted on day 8; she remained intubated. On day 9, fever with black stools ensued; abdominal CT performed on day 14 revealed colonic pneumatosis. Necrosis of the entire colon was observed during laparotomy; total colectomy was performed. The woman subsequently recovered, and 2 months after presentation, she was discharged to a rehabilitation centre. Author comment: "We present a case of delayed toxicity and bowel necrosis requiring total colectomy following a verapamil overdose." French LK, et al. Delayed bowel necrosis following overdose of sustained-release verapamil. Clinical Toxicology 50: 362 abstr. 337, No. 4, Apr 2012. Available from: URL: http://dx.doi.org/10.3109/15563650.2012.669957 - USA 803095419 1 Reactions 9 Nov 2013 No. 1477 0114-9954/13/1477-0001/$14.95 Adis © 2013 Springer International Publishing AG. All rights reserved
Transcript of Verapamil overdose
Reactions 1477, p33 - 9 Nov 2013
O SVerapamil overdose
Bowel necrosis: case reportA 41-year-old woman developed delayed bowel necrosis
after administering an intentional overdose of verapamil[Calan-SR].
The woman presented 2 hours after ingesting30 × verapamil 240mg tablets. Activated charcoal and calciumgluconate were initiated; she was moved to the ICU. Normalvital signs were noted until 14 hours post-ingestion. The firstsign of toxicity was bradycardia with a HR in the 40s;hypotension ensued followed by complete heart block andobtundation. She was intubated; hyperinsulin-euglyemiatherapy, transvenous pacer implantation, haemodialysis, andlipid emulsion therapy, for 48 hours, were necessitated.Haemodynamic recovery was noted on day 8; she remainedintubated. On day 9, fever with black stools ensued;abdominal CT performed on day 14 revealed colonicpneumatosis. Necrosis of the entire colon was observedduring laparotomy; total colectomy was performed.
The woman subsequently recovered, and 2 months afterpresentation, she was discharged to a rehabilitation centre.
Author comment: "We present a case of delayed toxicityand bowel necrosis requiring total colectomy following averapamil overdose."French LK, et al. Delayed bowel necrosis following overdose of sustained-releaseverapamil. Clinical Toxicology 50: 362 abstr. 337, No. 4, Apr 2012. Availablefrom: URL: http://dx.doi.org/10.3109/15563650.2012.669957 - USA 803095419
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Reactions 9 Nov 2013 No. 14770114-9954/13/1477-0001/$14.95 Adis © 2013 Springer International Publishing AG. All rights reserved
