Citation

Charpentier C, Flandrois M, Labombarda F, Maragnes P, Jokic M, Villedieu F. Arch. Pediatr. 2014; 21(12): 1344-1347.

Vernacular Title

Intoxication aigüe au vérapamil : attention à l'effet retard.

Affiliation

Service de réanimation pédiatrique, pôle Femme-Enfant, CHU de Caen, avenue de la Côte-de-Nacre, 14033 Caen cedex 9, France. Electronic address: villedieu-f@chu-caen.fr.

Copyright

(Copyright © 2014, Elsevier Publishing)

DOI

10.1016/j.arcped.2014.09.013

PMID

25445125

Abstract

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.

Language: fr