Cardiotoxic Overdose Treated with Intravenous Fat Emulsion and High-Dose Insulin in the Setting of Hypertrophic Cardiomyopathy

Journal of Medical Toxicology

Volumn 7, Issue 2, 2011, Pages 151-153

  Stellpflug, Samuel J ^a   Fritzlar, Sandy J ^b   Cole, Jon B ^a   Engebretsen, Kristin M ^a   Holger, Joel S ^a  

^a REGIONS HOSPITAL   (United States)

^b UNITED HOSPITAL   (United States)

Author keywords

Beta blockers; Calcium channel blockers; HDI; Hypertrophic cardiomyopathy; IFE; Intralipid

Indexed keywords

AMIODARONE; DILTIAZEM; INSULIN; LIPID EMULSION; METOPROLOL;

ABDOMINAL PAIN; ACUTE CONFUSION; ADULT; BLOOD SAMPLING; CARDIOTOXICITY; CASE REPORT; COMBINATION CHEMOTHERAPY; DEFIBRILLATION; DOSE RESPONSE; DRUG BLOOD LEVEL; DRUG DOSE ESCALATION; DRUG EFFECT; DRUG EFFICACY; DRUG MEGADOSE; DRUG OVERDOSE; ECHOCARDIOGRAPHY; EMERGENCY WARD; FEMALE; GENERAL CONDITION DETERIORATION; HEART EJECTION FRACTION; HUMAN; HYPERTROPHIC CARDIOMYOPATHY; INOTROPISM; INTENSIVE CARE UNIT; KIDNEY FAILURE; LENGTH OF STAY; OLIGURIA; OUTCOME ASSESSMENT; PATHOPHYSIOLOGY; REVIEW;

ADRENERGIC BETA-1 RECEPTOR ANTAGONISTS; ADULT; AMIODARONE; CARDIOMYOPATHY, HYPERTROPHIC; CARDIOTOXINS; DILTIAZEM; DOSE-RESPONSE RELATIONSHIP, DRUG; DRUG THERAPY, COMBINATION; FAT EMULSIONS, INTRAVENOUS; FEMALE; HUMANS; HYPOGLYCEMIC AGENTS; INSULIN; METOPROLOL; OVERDOSE; SUICIDE, ATTEMPTED; TREATMENT OUTCOME;

EID: 79959297014     PISSN: 15569039     EISSN: 19376995     Source Type: Journal    
DOI: 10.1007/s13181-010-0133-3     Document Type: Review

References (13)

1. Cave G, Harvey M (2009) Intravenous lipid emulsion as antidote beyond local anesthetic toxicity: a systematic review. Acad Emerg Med 16: 815-824.
2. Jamaty C, Bailey B, Larocque A, Notebaert E, Sanogo K, Chauny J (2010) Lipid emulsions in the treatment of acute poisoning: a systematic review of human and animal studies. Clin Toxicol 48: 1-27.
3. Shepherd G (2006) Treatment of poisoning caused by beta-adrenergic and calcium-channel blockers. Am J Health Syst Pharm 63: 1828-1835.
4. Stellpflug S, Harris C, Engebretsen K, Cole J, Holger J (2010) Intentional overdose with cardiac arrest treated with intravenous fat emulsion. Clin Toxicol 48(3): 227-229.
5. Rohrig T, Rundle D, Leifer W (1987) Fatality resulting from metoprolol overdose. J Anal Toxicol 11: 231-232.
6. Cantrell F, Williams S (2005) Fatal unintentional overdose of diltiazem with antemortem and postmortem values. Clin Toxicol 43: 587-588.
7. Schoffstall J, Spivey W, Gambone L, Shaw R, Sit S (1991) Effects of calcium channel blocker overdose-induced toxicity in the conscious dog. Ann Emerg Med 20: 1104-1108.
8. Goddard C, Whorwell P (1989) Amiodarone overdose and its management. Br J Clin Pract 43: 184-186.
9. Maron B (2002) Hypertrophic cardiomyopathy: a systematic review. JAMA 287: 1308-1320.
10. i-independent positive inotropic effects in failing human myocardium. Circulation 111: 2588-2595.
11. Holger JS, Engebretsen KM, Fritzlar SJ, Patten LC, Harris CR, Flottemesch TJ (2007) Insulin versus vasopressin and epinephrine to treat beta-blocker toxicity. Clin Toxicol 45: 96-401.
12. Moffat A, Osselton M, Widdop B, Galichet L (eds) (2004) Part 2, monographs. In: Clarke's analysis of drugs and poisons in pharmaceuticals, body fluids, and postmortem material, 3rd edn. Pharmaceutical Press, London, pp 567-1721.
13. Holstege CP, Kirk MA, Furbee RB, Wermuth ME (1998) Wide complex dysrhythmia in calcium channel blocker overdose responsive to sodium bicarbonate therapy. J Toxicol Clin Toxicol 36: 509.