[Successful treatment by 4--aminopyridine of three cases of severe verapamil poisoning].
Three cases of verapamil intoxication were presented. In all cases shock and circulatory insufficiency were observed. In case no. 1 respiratory insufficiency and confusion were observed, in case no. 3 second-degree atrioventricular block was noted. The protracted hypotension (shock), circulatory insufficiency and atrioventricular block did not respond to calcium therapy, high dose of vasopressor amines and atropine. The addition of 4-aminopyridine (4-AP) infusion resulted in fast receding of poisoning symptoms; receding of atrioventricular block, cardiogenic shock and circulatory insufficiency. These cases suggest the usefulness of 4-AP in the treatment of verapamil poisoning. However, confirmation of the effectiveness of this substance for pharmacotherapy of calcium antagonists poisoning requires further clinical research. The influence of 4-AP on calcium channels is indirect. It blocks potassium channels K1 in cytoplasm side which makes potassium to stay inside the cell leading to depolarisation and opening of voltage-dependent calcium channels.
Katedra i Zakład Farmakologii Akademii Medycznej we Wrocławiu, 50-345 Wrocław, ul. Mikulicza-Radeckiego 2.
Jan
J
Magdalan
Krystyna
K
Kochman
Andrzej
A
Antończyk
Michal
M
Przewłocki
Małgorzata
M
Smolarek
D015761:4-Aminopyridine / Q000627:therapeutic use*; D000328:Adult; D005260:Female; D006327:Heart Block / Q000139:chemically induced* / Q000188:drug therapy*; D006801:Humans; D008875:Middle Aged; D026902:Potassium Channel Blockers / Q000627:therapeutic use*; D013406:Suicide, Attempted / Q000523:psychology*; D014665:Vasodilator Agents / Q000506:poisoning*; D014700:Verapamil / Q000506:poisoning*
D026902:Potassium Channel Blockers; D014665:Vasodilator Agents; D015761:4-Aminopyridine; D014700:Verapamil