PMID- 30150339
OWN - NLM
STAT- MEDLINE
DCOM- 20181212
LR  - 20230928
IS  - 1757-790X (Electronic)
IS  - 1757-790X (Linking)
VI  - 2018
DP  - 2018 Aug 27
TI  - Pharmacological and mechanical management of calcium channel blocker toxicity.
LID - bcr-2018-225324 [pii]
LID - 10.1136/bcr-2018-225324 [doi]
LID - bcr2018225324
AB  - Cardiovascular instability associated with calcium channel blocker toxicity 
      comprises a small percentage of overdose presentations, yet they are associated 
      with a high mortality rate. We detail the management of a 64-year-old man who 
      took an intentional overdose of 840 mg nimodipine. We include the treatment he 
      received and highlight the scarcity of evidence behind the use of gastric 
      decontamination, calcium, glucagon, intravenous lipid emulsion, high-dose insulin 
      therapy, sodium bicarbonate, vasopressors and methylene blue in calcium channel 
      blocker toxicity. Additionally, the article explores the use of electrical pacing 
      and venoarterial extracorporeal membrane oxygenation (VA-ECMO). Following 
      successful weaning of VA-ECMO, the patient was successfully extubated but 
      remained neurologically impaired due to hypoxic-ischaemic brain injury, critical 
      care polyneuropathy and renal failure requiring dialysis. He has cerebral 
      performance category 3; he has mild cognitive impairment but able to perform some 
      activities of daily living independently and communicate his thoughts and needs. 
      He requires no respiratory or cardiovascular support.
CI  - (c) BMJ Publishing Group Limited 2018. No commercial re-use. See rights and 
      permissions. Published by BMJ.
FAU - Fadhlillah, Fiqry
AU  - Fadhlillah F
AUID- ORCID: 0000-0002-2013-9996
AD  - Emergency Department, Chelsea and Westminster Hospital NHS Foundation Trust, 
      London, UK.
FAU - Patil, Shashank
AU  - Patil S
AD  - Emergency Department, Chelsea and Westminster Hospital NHS Foundation Trust, 
      London, UK.
LA  - eng
PT  - Case Reports
PT  - Journal Article
DEP - 20180827
PL  - England
TA  - BMJ Case Rep
JT  - BMJ case reports
JID - 101526291
RN  - 0 (Calcium Channel Blockers)
RN  - 0 (Fat Emulsions, Intravenous)
RN  - 57WA9QZ5WH (Nimodipine)
SB  - IM
MH  - Acute Kidney Injury/chemically induced
MH  - Calcium Channel Blockers/*poisoning
MH  - Combined Modality Therapy
MH  - Drug Overdose/*therapy
MH  - Extracorporeal Membrane Oxygenation
MH  - Fat Emulsions, Intravenous/administration & dosage
MH  - Humans
MH  - Hypoxia-Ischemia, Brain/chemically induced
MH  - Male
MH  - Middle Aged
MH  - Nimodipine/*poisoning
MH  - Polyneuropathies/chemically induced
MH  - Suicide, Attempted
MH  - Treatment Outcome
PMC - PMC6119390
OTO - NOTNLM
OT  - drugs and medicines
OT  - emergency medicine
OT  - poisoning
COIS- Competing interests: None declared.
EDAT- 2018/08/29 06:00
MHDA- 2018/12/13 06:00
PMCR- 2020/08/27
CRDT- 2018/08/29 06:00
PHST- 2018/08/29 06:00 [entrez]
PHST- 2018/08/29 06:00 [pubmed]
PHST- 2018/12/13 06:00 [medline]
PHST- 2020/08/27 00:00 [pmc-release]
AID - bcr-2018-225324 [pii]
AID - 10.1136/bcr-2018-225324 [doi]
PST - epublish
SO  - BMJ Case Rep. 2018 Aug 27;2018:bcr2018225324. doi: 10.1136/bcr-2018-225324.