Ramoska E A, Spiller H A, Winter M, Borys D
Division of Emergency Medicine, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
Ann Emerg Med. 1993 Feb;22(2):196-200. doi: 10.1016/s0196-0644(05)80202-1.
To examine the cardiovascular toxicity of calcium channel blockers and the efficacy of various treatments.
Case series collected prospectively over one year.
Three regional poison control centers.
One hundred thirty-nine hospitalized patients who had ingested a calcium channel blocker.
Calcium, dopamine, atropine, isoproterenol, glucagon, and pacemakers.
Hypotension, sinus node suppression, and dysrhythmias often occur with calcium channel blocker overdoses, but atrioventricular nodal block occurs more often with verapamil (chi 2 test, P < .025). Calcium was administered to 23 patients and was efficacious in reversing depression of cardiac conduction and increasing blood pressure. Dopamine was administered to ten patients and was efficacious in increasing blood pressure. Atropine was administered to eight patients, but only two had a positive response.
Atrioventricular nodal depression is more common with verapamil overdoses. Calcium and dopamine are useful in treating toxicity from calcium channel blocker overdose, whereas atropine is sometimes useful.
探讨钙通道阻滞剂的心血管毒性及各种治疗方法的疗效。
前瞻性收集为期一年的病例系列。
三个地区毒物控制中心。
139例因摄入钙通道阻滞剂而住院的患者。
钙剂、多巴胺、阿托品、异丙肾上腺素、胰高血糖素和起搏器。
钙通道阻滞剂过量常导致低血压、窦房结抑制和心律失常，但维拉帕米过量时房室传导阻滞更常见（卡方检验，P < 0.025）。23例患者使用了钙剂，钙剂在逆转心脏传导抑制和升高血压方面有效。10例患者使用了多巴胺，多巴胺在升高血压方面有效。8例患者使用了阿托品，但只有2例有阳性反应。
维拉帕米过量时房室传导抑制更常见。钙剂和多巴胺对治疗钙通道阻滞剂过量中毒有效，而阿托品有时有效。
