title: Whole bowel irrigation and the hemodynamically unstable calcium channel blocker overdose: primum non nocere.
abstract: Sustained-release calcium channel blocker (CCB SR) overdoses are potentially life-threatening ingestions. These patients may not become hemodynamically unstable until many hours after ingestion. On theoretical grounds, some have suggested that whole bowel irrigation (WBI) with polyethylene glycol electrolyte lavage solution may be of value in the management of these cases. We report two cases with poor outcome (including one fatality) that were complicated by the use of WBI. Both cases were treated with WBI beginning before and continuing after developing hypotension. WBI should be avoided in the setting of the hemodynamically unstable CCB SR overdose.
authors.affiliation: The Toxikon Consortium at Cook County Hospital, Chicago, Illinois 60612, USA.
authors.forename: Kirk L
authors.initials: KL
authors.lastname: Cumpston
authors.forename: Steven E
authors.initials: SE
authors.lastname: Aks
authors.forename: Todd
authors.initials: T
authors.lastname: Sigg
authors.forename: Erin
authors.initials: E
authors.lastname: Pallasch
mesh_terms: D001291:Attitude of Health Personnel; D002121:Calcium Channel Blockers / Q000506:poisoning*; D062787:Drug Overdose; D006439:Hemodynamics; D006801:Humans; D007422:Intestines / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D013406:Suicide, Attempted / Q000523:psychology; D007507:Therapeutic Irrigation / Q000379:methods*
chemical_list: D002121:Calcium Channel Blockers