Roper T A, Sykes R, Gray C
Ladywell Hospital, Salford, UK.
Postgrad Med J. 1993 Jun;69(812):474-6. doi: 10.1136/pgmj.69.812.474.
Four fatal cases of diltiazem overdose are described and compared with previously published cases. Clinical sequelae include all grades of heart block, hypotension and ultimately death. Management includes gastric lavage and oral administration of activated charcoal at presentation. Further symptomatic treatment with inotropic agents and temporary cardiac pacing may be required. If these measures are successful, recovery occurs within 36 hours in uncomplicated cases. Toxicological data have been reviewed but currently drug levels can only offer a retrospective analysis of the severity of overdoses. As the use and risk of abuse of diltiazem increases, these reports serve to highlight the possible hazards and to alert physicians to what must be regarded as a dangerous and potentially lethal drug in overdosage.
本文描述了4例地尔硫䓬过量致死的病例，并与先前发表的病例进行了比较。临床后遗症包括各级心脏传导阻滞、低血压，最终导致死亡。处理措施包括就诊时进行洗胃和口服活性炭。可能需要进一步使用正性肌力药物进行对症治疗以及临时心脏起搏。如果这些措施成功，无并发症的病例在36小时内即可康复。已对毒理学数据进行了审查，但目前药物水平仅能对过量用药的严重程度进行回顾性分析。随着地尔硫䓬使用和滥用风险的增加，这些报告旨在强调可能的危害，并提醒医生注意这种过量使用时被视为危险且可能致命的药物。
