[Attempted suicide with sustained release diltiazem].
A 15-year-old woman was admitted to the intensive care unit after intentional auto-intoxication with 10 tablets of 200 mg diltiazem sustained release. She developed hypotension and became oliguric. This was followed by metabolic acidosis. Maximum plasma lactate concentration was 10 mmol/l and the highest measured plasma diltiazem level was 500 micrograms/l. The occurrence of pulmonary oedema due to adult respiratory distress syndrome (ARDS) was striking and the patient required mechanical ventilation for a period of three days as a result of this. After five days in the intensive care unit, she was transferred to a psychiatric hospital in a good physical condition. Sustained release diltiazem intoxications have previously been described on five occasions.
Quispel
R
R
Medisch Centrum Haaglanden, locative Westeinde, afd. Intensive Care, Den Haag.
Baur
H J
HJ
D000140:Acidosis, Lactic / Q000139:chemically induced; D000293:Adolescent; D000959:Antihypertensive Agents / Q000506:poisoning*; D003422:Critical Care / Q000379:methods; D003692:Delayed-Action Preparations; D004110:Diltiazem / Q000097:blood / Q000506:poisoning*; D062787:Drug Overdose; D005260:Female; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D009846:Oliguria / Q000139:chemically induced; D012128:Respiratory Distress Syndrome / Q000139:chemically induced* / Q000628:therapy; D013406:Suicide, Attempted / Q000523:psychology*; D016896:Treatment Outcome
D000959:Antihypertensive Agents; D003692:Delayed-Action Preparations; D004110:Diltiazem