In:
Nihon Kyukyu Igakukai Zasshi: Journal of Japanese Association for Acute Medicine, Wiley, Vol. 33, No. 3 ( 2022-03), p. 110-115
Abstract:
A combined overdose of beta–blockers and calcium–channel blockers causes hemodynamic instability. Using this combination produces a stronger effect than using only one of the drugs on patients requiring ventilation or vasopressor support. We describe a case of metoprolol and verapamil overdose, which developed into cardiac arrest and refractory shock after the return of spontaneous circulation, and was successfully treated with veno–arterial extracorporeal membrane oxygenation (V–A ECMO). A 61–year–old woman presented with cardiac arrest after overdosing on propranolol (1,200mg) and verapamil (1,200mg), prescribed for palpitations. She ingested them because she felt strong palpitations that day. Advanced life support was initiated, resulting in the return of spontaneous circulation after adrenaline (8mg) administration and intubation. As the patient remained in shock despite maximal vasopressor support, she was administered V–A ECMO. She was decannulated from ECMO after three days. She developed aspiration pneumonia, which was treated by reintubation and tracheostomy. She was discharged with a favorable neurological prognosis after a 68–day hospitalization. Combined propranolol and verapamil poisoning may cause cardiac arrest even in small doses. Emergency V–A ECMO effectively treats severe combined poisoning with beta–blockers and calcium–channel blockers.
Type of Medium:
Online Resource
ISSN:
1883-3772
,
1883-3772
DOI:
10.1002/jja2.2022.v33.3
Language:
English
Publisher:
Wiley
Publication Date:
2022
detail.hit.zdb_id:
2846771-1