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Journal of The Korean Society of Emergency Medicine 1998;9(1): 169-176. |
A Case of Sustained-release Verapamil Intoxication due to Overdose |
Chang Don Kang, Sang Wook Kim, Eung Ju Kim, Eun Mi Lee, Chang Kyu Park, Hong Seok Seo, Young Joo Kwon, Heui Jung Pyo, Dong Joo Oh |
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ABSTRACT |
Verapamil overdose results in cardiac arrhythmia including the complete A-V block, and hypotension due to decreased peripheral resistance and decreased myocardial contractility. However, sustained-release verapamil overdose frequently has atypical presentations, such as delayed and prolonged course of toxic signs and symptoms. Although several cases of sustained-release verapamil overdose have been reported worldwidely, the specific treatment modalities and prognostic indicators for verapamil overdose have not been well-defined.
Recently, we experienced a case of sustained-release verapamil overdose in 30-year-old female. 10 hours after verapamil ingestion she presented in severe bradycardia and hypotensive shock state. Initial EKG showed the complete AV block and her systolic blood pressure was below 60 mmHg.
Temporary cardiac pacemaker was performed and she was treated with activated charcoal, glucagon, amrinone, and several sympathomimetics, and 48 hours after admission, she was fully recovered. |
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