alexa Calcium Channel Blocker Toxicity in a Cirrhotic Patient
ISSN: 2329-6607

Cardiovascular Pharmacology: Open Access
Open Access

OMICS International organises 3000+ Global Conferenceseries Events every year across USA, Europe & Asia with support from 1000 more scientific Societies and Publishes 700+ Open Access Journals which contains over 50000 eminent personalities, reputed scientists as editorial board members.

Open Access Journals gaining more Readers and Citations

700 Journals and 15,000,000 Readers Each Journal is getting 25,000+ Readers

This Readership is 10 times more when compared to other Subscription Journals (Source: Google Analytics)

Case Report

Calcium Channel Blocker Toxicity in a Cirrhotic Patient

Panagis Galiatsatos*, Dachelle Johnson, Ryan E Childers, Deeptankar Demazumder and Sammy Zakaria

Department of Medicine, Johns Hopkins Bayview Medical Center, Johns Hopkins University School of Medicine, Baltimore, USA

Corresponding Author:
Panagis Galiatsatos
Department of Medicine
Johns Hopkins Bayview Medical Center
4940 Eastern Avenue, Baltimore, USA
Tel: 410- 550-0526
Fax: 410-550-1183
E-mail: [email protected]

Received date: November 08, 2012; Accepted date: December 17, 2012; Published date: December 19, 2012

Citation: Galiatsatos P, Johnson D, Childers RE, Demazumder D, Zakaria S (2013) Calcium Channel Blocker Toxicity in a Cirrhotic Patient. Cardiol Pharmacol 2:106. doi:10.4172/2329-6607.1000106

Copyright: © 2013 Galiatsatos P, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

 

Abstract

Objective To report a case of profound bradycardia as a result of verapamil toxicity due to impaired metabolism in acirrhotic patient. Case report A 57 year old man with cirrhosis presented with weakness and syncope and a heart rate of twenty beats per minute (bpm). Despite treatment with transcutaneous cardiac pacing, he developed a systole and required eight minutes of cardiopulmonary resuscitation before circulation was restored. After reviewing his medication list, verapamil toxicity was suspected as the etiology for his cardiovascular collapse because of the drug’s poor metabolic clearance in hepatic dysfunction. He was treated for calcium channel blocker toxicity, with calcium, insulin and dextrose infusions. By the seventh day, his blood pressure and heart rate were stable without invasive interventions. However, his liver was unable to recover from the initial shock, leading to the patient’s death. Discussion Calcium Channel Blocker (CCB) toxicity is associated with significant morbidity and mortality and is often diagnosed at the time of presentation (e.g. history of overdose). Treatment options include calcium infusion, which can lead to improvements in conduction, inotropy, and blood pressure; and high-dose insulin, which improves myocardial metabolism. These therapies were implemented in the patient, leading to hemodynamic stability, even in the setting of cirrhosis. Conclusion Caution is warranted when prescribing calcium channel blockers, such as verapamil, to patients with cirrhosis, since hepatic clearance will most likely be impaired, and may be associated with adverse events. If cirrhotic patients develop CCB toxicity, management is difficult, with few reports of specific treatment strategies.

Share This Page

Additional Info

Loading
Loading Please wait..
 
Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2017-18
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri, Food, Aqua and Veterinary Science Journals

Dr. Krish

[email protected]

1-702-714-7001 Extn: 9040

Clinical and Biochemistry Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Business & Management Journals

Ronald

[email protected]

1-702-714-7001Extn: 9042

Chemical Engineering and Chemistry Journals

Gabriel Shaw

[email protected]

1-702-714-7001 Extn: 9040

Earth & Environmental Sciences

Katie Wilson

[email protected]

1-702-714-7001Extn: 9042

Engineering Journals

James Franklin

[email protected]

1-702-714-7001Extn: 9042

General Science and Health care Journals

Andrea Jason

[email protected]

1-702-714-7001Extn: 9043

Genetics and Molecular Biology Journals

Anna Melissa

[email protected]

1-702-714-7001 Extn: 9006

Immunology & Microbiology Journals

David Gorantl

[email protected]

1-702-714-7001Extn: 9014

Informatics Journals

Stephanie Skinner

[email protected]

1-702-714-7001Extn: 9039

Material Sciences Journals

Rachle Green

[email protected]

1-702-714-7001Extn: 9039

Mathematics and Physics Journals

Jim Willison

[email protected]

1-702-714-7001 Extn: 9042

Medical Journals

Nimmi Anna

[email protected]

1-702-714-7001 Extn: 9038

Neuroscience & Psychology Journals

Nathan T

[email protected]

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

John Behannon

[email protected]

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

[email protected]

1-702-714-7001 Extn: 9042

 
© 2008-2017 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
adwords