Successful treatment with enoximone for severe poisoning with atenolol and verapamil: a case report.
Combined poisoning with calcium channel blockers (CCBs) and beta-blockers is usually associated with severe hypotension and heart failure. Due to the block of the beta receptors, treatment with adrenergic agonists, even at high doses, can be insufficient, and beta-independent inotropes, such as glucagon, may be required. Phosphodiesterase III (PDEIII) inhibitors represent a possible alternative to glucagon in these cases as they have an inotropic effect which is not mediated by a beta receptor.
Sandroni
C
C
Department of Anesthesiology and Intensive Care, Catholica University School of Medicine, Rome, Italy.
Cavallaro
F
F
Addario
C
C
Ferro
G
G
Gallizzi
F
F
Antonelli
M
M
D000322:Adrenergic Agonists / Q000008:administration & dosage; D000889:Anti-Arrhythmia Agents / Q000506:poisoning*; D001262:Atenolol / Q000506:poisoning*; D001794:Blood Pressure / Q000187:drug effects; D002302:Cardiac Output / Q000187:drug effects; D002316:Cardiotonic Agents / Q000627:therapeutic use*; D004298:Dopamine / Q000008:administration & dosage; D062787:Drug Overdose; D017335:Enoximone / Q000627:therapeutic use*; D004837:Epinephrine / Q000008:administration & dosage; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D014700:Verapamil / Q000506:poisoning*
D000322:Adrenergic Agonists; D000889:Anti-Arrhythmia Agents; D002316:Cardiotonic Agents; D001262:Atenolol; D017335:Enoximone; D014700:Verapamil; D004298:Dopamine; D004837:Epinephrine