Levosimendan as Treatment Option in Severe Verapamil Intoxication: A Case Report and Review of the Literature
Cardiovascular shock due to verapamil intoxication is often refractory to standard resuscitation methods. Recommended therapy includes prevention of further absorption of the drug, inotropic therapy, calcium gluconate, and hyperinsulinemia/euglycemia therapy. Often further measures are needed such a...
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| Format: | Article |
| Language: | English |
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Wiley
2010-01-01
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| Series: | Case Reports in Medicine |
| Online Access: | http://dx.doi.org/10.1155/2010/546904 |
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| author | Mirjam Osthoff Christine Bernsmeier Stephan C. Marsch Patrick R. Hunziker |
| author_facet | Mirjam Osthoff Christine Bernsmeier Stephan C. Marsch Patrick R. Hunziker |
| author_sort | Mirjam Osthoff |
| collection | DOAJ |
| description | Cardiovascular shock due to verapamil intoxication is often refractory to standard resuscitation methods. Recommended therapy includes prevention of further absorption of the drug, inotropic therapy, calcium gluconate, and hyperinsulinemia/euglycemia therapy. Often further measures are needed such as ventricular pacing or mechanical circulatory support. Still, mortality remains high.
Levosimendan, an inotropic agent, that enhances myofilament response to calcium, increases myocardial contraction and could therefore be beneficial in verapamil intoxication. Here, we report the case of a 60-year-old patient with clinically severe verapamil poisoning who presented with shock, bradycardia, and sopor. Standard therapy including high-dose inotropes failed to ameliorate the signs of intoxication. But additional therapy with levosimendan led to rapid improvement. Based on this observation, the literature is reviewed focusing on utilization of levosimendan in the treatment of calcium channel blocker overdose. We suggest to consider levosimendan as additional treatment option in patients with cardiovascular shock due to verapamil intoxication that are refractory to standard management. |
| format | Article |
| id | doaj-art-a2200470369849a2addc3e9a03dc3e0c |
| institution | Kabale University |
| issn | 1687-9627 1687-9635 |
| language | English |
| publishDate | 2010-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Medicine |
| spelling | doaj-art-a2200470369849a2addc3e9a03dc3e0c2025-02-03T01:27:18ZengWileyCase Reports in Medicine1687-96271687-96352010-01-01201010.1155/2010/546904546904Levosimendan as Treatment Option in Severe Verapamil Intoxication: A Case Report and Review of the LiteratureMirjam Osthoff0Christine Bernsmeier1Stephan C. Marsch2Patrick R. Hunziker3Medical Intensive Care Unit, University Hospital Basel, 4031 Basel, SwitzerlandMedical Intensive Care Unit, University Hospital Basel, 4031 Basel, SwitzerlandMedical Intensive Care Unit, University Hospital Basel, 4031 Basel, SwitzerlandMedical Intensive Care Unit, University Hospital Basel, 4031 Basel, SwitzerlandCardiovascular shock due to verapamil intoxication is often refractory to standard resuscitation methods. Recommended therapy includes prevention of further absorption of the drug, inotropic therapy, calcium gluconate, and hyperinsulinemia/euglycemia therapy. Often further measures are needed such as ventricular pacing or mechanical circulatory support. Still, mortality remains high. Levosimendan, an inotropic agent, that enhances myofilament response to calcium, increases myocardial contraction and could therefore be beneficial in verapamil intoxication. Here, we report the case of a 60-year-old patient with clinically severe verapamil poisoning who presented with shock, bradycardia, and sopor. Standard therapy including high-dose inotropes failed to ameliorate the signs of intoxication. But additional therapy with levosimendan led to rapid improvement. Based on this observation, the literature is reviewed focusing on utilization of levosimendan in the treatment of calcium channel blocker overdose. We suggest to consider levosimendan as additional treatment option in patients with cardiovascular shock due to verapamil intoxication that are refractory to standard management.http://dx.doi.org/10.1155/2010/546904 |
| spellingShingle | Mirjam Osthoff Christine Bernsmeier Stephan C. Marsch Patrick R. Hunziker Levosimendan as Treatment Option in Severe Verapamil Intoxication: A Case Report and Review of the Literature Case Reports in Medicine |
| title | Levosimendan as Treatment Option in Severe Verapamil Intoxication: A Case Report and Review of the Literature |
| title_full | Levosimendan as Treatment Option in Severe Verapamil Intoxication: A Case Report and Review of the Literature |
| title_fullStr | Levosimendan as Treatment Option in Severe Verapamil Intoxication: A Case Report and Review of the Literature |
| title_full_unstemmed | Levosimendan as Treatment Option in Severe Verapamil Intoxication: A Case Report and Review of the Literature |
| title_short | Levosimendan as Treatment Option in Severe Verapamil Intoxication: A Case Report and Review of the Literature |
| title_sort | levosimendan as treatment option in severe verapamil intoxication a case report and review of the literature |
| url | http://dx.doi.org/10.1155/2010/546904 |
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