Citation

Trappe HJ. Notfall Rettungsmed. 2012; 15(7): 577-585.

Copyright

(Copyright © 2012, Holtzbrinck Springer Nature Publishing Group)

DOI

10.1007/s10049-012-1579-4

PMID

unavailable

Abstract

Background. In 60-70% of intoxications (Int) in adults, the purpose of drug administration is a suicide attempt. In 15-25% of patients, drug ingestion is accidental and in 5% commercial. Among all toxic agents, pharmaceutical drugs are responsible for Int in 80-90% of patients. Most frequent drugs for Int are psychotropic drugs or hypnotics. Cardiovascular drugs are rarely the cause for Int, but digitalis (dig) and betablocking (BB) intoxications are known. Diagnosis. In patients with Int, history, physical examination and the 12-lead surface ECG are essential because most Int due to cardiovascular drugs lead to supraventricular or ventricular arrhythmias. Dig Int leads most frequently to atrioventricular conduction disturbances (AV-blocks), BB Int leads to sinuatrial or AV nodal conduction disturbances, bradycardia and hypotonia. Calcium antagonist Int is associated with AV-conduction disturbances or cardiac arrest. QT prolongation and torsade de pointes tachycardia are greatly feared when class I and III antiarrhythmic drugs were used. Salicylate Int is mostly associated with central nervous system disturbances.Therapy. It is necessary to treat all Int patients in the intensive care unit. In AV conduction disturbances atropine or temporary pacemaker stimulation is recommended. Patients with dig Int should be given a dig antidote, while patients with AD and torsade de pointes tachycardia and/or ventricular fibrillation need direct current cardioversion/defibrillation. Hemodialysis is necessary in severe salicylate Int. © Springer-Verlag Berlin Heidelberg 2012.

Language: de

Keywords

Intoxication; human; hemodialysis; disease severity; article; antiarrhythmic agent; drug intoxication; tachycardia; physical examination; intensive care unit; heart muscle conduction disturbance; beta adrenergic receptor blocking agent; heart arrest; anamnesis; antidote; atropine; calcium antagonist; QT prolongation; defibrillation; electrocardiogram; salicylic acid; Calcium channel blockers; torsade des pointes; bradycardia; cardiovascular agent; central nervous system disease; muscle hypotonia; digitalis; atrioventricular block; heart ventricle arrhythmia; cardioversion; pacemaker; Salicylates; Antiarrhythmic drugs; heart supraventricular arrhythmia; Beta-Adrenergic blockers; heart fibrillation; sinus node disease