Citation

Tuka V, Ricarova B, Janota T, Malik J, Kotrlikova E. Eur. J. Emerg. Med. 2009; 16(2): 100-102.

Copyright

(Copyright © 2009, Lippincott Williams and Wilkins)

DOI

10.1097/MEJ.0b013e32830a997c

PMID

19194302

Abstract

We present a case report of intoxication by a potentially lethal dose of sustained-release verapamil with delayed escalation of complications. The patient was hospitalized 1.5 h after an attempted suicide with a very high dose of verapamil sustained-release (7.2 g). On admission the plasma concentrations were extremely high (3600 ng/l). Heart rate and blood pressure declined slowly with a surprising sudden escalation on the third day coupled with hemodynamic collapse and loss of consciousness. Complete recovery was achieved in spite of 2 h of extreme hypotension. We outline the clinical course, a need for massive bowel irrigation in case of sustained-release medication, the timing of a temporary pacing and the effect of centralization of circulation even on invasively measured blood pressure.

Language: en

Keywords

Aged; Blood Pressure Determination; Calcium Channel Blockers; Coma; Delayed-Action Preparations; Humans; Hypotension; Male; Suicide, Attempted; Verapamil