[Therapy of verapamil poisoning with noradrenaline and the phosphodiesterase inhibitor enoximone].
METHODS
A 40 year old patient was transferred to the intensive care unit five hours after the ingestion of 2.4 g of verapamil.


METHODS
Clinical investigation and invasive monitoring showed signs of cardiogenic shock.


METHODS
Despite primary detoxification and administration of calcium and norepinephrine no adequate cardiovascular stabilization could be achieved. Only when the phosphodiesterase inhibitor enoximone was added, an increase in myocardial inotropy and a stable cardiovascular state was achieved which was also due to the vasoconstrictory effect of norepinephrine overcoming vasodilatation induced by enoximone.


CONCLUSIONS
Detoxification, calcium supplementation and catecholamines are established therapeutic measures. An additional therapy with phosphodiesterase inhibitors is a promising step in conquering predominant heart failure and hypotension.
D000328:Adult; D002118:Calcium / Q000008:administration & dosage; D002121:Calcium Channel Blockers / Q000506:poisoning*; D004359:Drug Therapy, Combination; D017335:Enoximone / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D009638:Norepinephrine / Q000627:therapeutic use*; D010726:Phosphodiesterase Inhibitors / Q000627:therapeutic use*; D011041:Poisoning / Q000150:complications / Q000188:drug therapy; D012770:Shock, Cardiogenic / Q000139:chemically induced / Q000188:drug therapy; D013566:Sympathomimetics / Q000627:therapeutic use*; D014662:Vasoconstrictor Agents / Q000627:therapeutic use; D014665:Vasodilator Agents / Q000506:poisoning; D014700:Verapamil / Q000506:poisoning*
D002121:Calcium Channel Blockers; D010726:Phosphodiesterase Inhibitors; D013566:Sympathomimetics; D014662:Vasoconstrictor Agents; D014665:Vasodilator Agents; D017335:Enoximone; D014700:Verapamil; D002118:Calcium; D009638:Norepinephrine
Therapie der Verapamil-Intoxikation mit Noradrenalin und dem Phosphodiesterasehemmer Enoximon.