Cantrell F Lee, Williams Saralyn R
California Poison Control System, San Diego Division, San Diego, California 92103-8925, USA.
Clin Toxicol (Phila). 2005;43(6):587-8. doi: 10.1081/clt-200068860.
Therapeutic errors involving calcium channel antagonists (CCA) resulting in death rarely have been reported in detail. We report a fatality from an unintentional overdose of sustained-release (SR) diltiazem including antemortem and postmortem blood concentrations.
A 65-year-old man with aortic stenosis mistakenly took six tablets of diltiazem 360 mg SR. He developed symptoms of toxicity by 7 hours after ingestion. By 10 hours, he went to the emergency department. Despite a prolonged resuscitative attempt, the patient died 17 hours postingestion. An antemortem blood sample drawn 11.5 hours after ingestion was 2.9 mcg/mL. Postmortem gas chromatography of central blood revealed a diltiazem level of 6 mcg/mL and the peripheral blood sample measured 5 mcg/ mL.
This case suggests that an unintentional overdose with a CCA may be lethal if the patient's cardiovascular ability to compensate for the toxic effects is compromised.
涉及钙通道拮抗剂（CCA）导致死亡的治疗错误鲜有详细报道。我们报告一例因意外过量服用缓释（SR）地尔硫䓬导致死亡的病例，包括生前和死后血液浓度情况。
一名65岁主动脉瓣狭窄男性误服6片360毫克SR地尔硫䓬。服药7小时后出现中毒症状。10小时后前往急诊科。尽管进行了长时间的复苏尝试，患者在服药17小时后死亡。服药11.5小时后采集的生前血样浓度为2.9微克/毫升。死后中心血样气相色谱分析显示地尔硫䓬水平为6微克/毫升，外周血样浓度为5微克/毫升。
该病例表明，如果患者心血管系统对毒性作用的代偿能力受损，意外过量服用CCA可能会致命。
