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  • Insulin as adjunctive therapy for calcium channel blocker toxicity = Zdravljenje z inzulinom pri zastrupitvi z zaviralci kalcijevih kanalčkov
    Bunc, Matjaž ; Možina, Hugon ; Brvar, Miran
    Calcium channel blockers (CCB) act on L-type calcium channels in cardiac and vascular smooth muscles preventing calcium influx into cells with resultant decrease in vascular tone and cardiac ... inotropy, chronotropy and dromotropy. Poisoning with calcium channel blockers results in reduced cardiac output, bradycardia, atrioventricular block, hypotension and shock. The case of a 49-year-old man with a medical history of arterial hypertension and alcohol abuse and concomitant heart failure is reported. Cardiogenic shock developed 10 days after introduction of verapamil treatment. Specific treatment includedcalcium, glucagon and supportive care, including the use of catecholamines. After normal coronarogram and development of cardiogenic shock, a balloon aortic pump was introduced. Insulin, which proved especially useful in shocked patients, was initiated. The patient's clinical picture. especially his heart function, improved in the next few minutes. Myocardial biopsy revealed alcoholic cardiomyopathy. ln this case, verapamil merely manifested an already existing heart failure, therefore the effects of therapy, including insulin/glucose infusion, were limited. Insulin/glucose infusion is suggested in patients shocked due to CCB effects.
    Vir: Slovenska kardiologija : znanstveno strokovna revija za področje srčno-žilne medicine. - ISSN 1581-8543 (Vol. 2, no. 2, 2005, str. 130-135)
    Vrsta gradiva - članek, sestavni del
    Leto - 2005
    Jezik - angleški
    COBISS.SI-ID - 20130521

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