title: Role of intravenous lipid emulsions in the management of calcium channel blocker and β-blocker overdose: 3 years experience of a university hospital.
abstract: OBJECTIVE
  The objective of this study was to assess the efficacy of lipid emulsion as antidotal therapy in severe calcium channel blocker (CCB) and β-blocker (BB) intoxications.
  
  
  METHODS
  This is a retrospective study in which we have summarized data of patients who were admitted to a university-based emergency department in a period of 3 years and were given intravenous lipid emulsion (ILE) to manage cardiogenic shock due to CCB and BB overdose.
  
  
  RESULTS
  We identified 15 patients who received ILE therapy for CCB and BB toxicity. Hospitalization durations variated between 3 and 33 days (mean 7.46 ± 7.41 days). Drug exposures included CCBs (n = 8, 53.3%), CCBs and paracetamol (n = 1, 6.6%), and BBs (n = 6, 40%). ILE therapy was effective in 12 patients (80%). Three patients (20%) had resistant hypotension, one of whom progressed to pulmonary edema. Adverse effects of ILE therapy were seen in three patients (20%). Two patients underwent mechanical ventilation. Two patients developed hypoxic ischemic encephalopathy, one patient died, and 14 patients (93.3%) were discharged from hospital.
  
  
  CONCLUSIONS
  There was 93.3% survival in patients receiving ILE for drug-induced cardiovascular collapse. Clinically significant adverse effects were uncommon. We suggest ILE administration for the treatment of cardiogenic shock due to CCB and BB overdose.
authors: Cukurova University, School of Medicine, Emergency Medicine , Adana , Turkey.
authors: Ahmet
authors: A
authors: Sebe
authors: Nezihat Rana
authors: NR
authors: Dişel
authors: Ayça
authors: A
authors: Açıkalın Akpınar
authors: Emre
authors: E
authors: Karakoç
mesh_terms: D000293:Adolescent; D000319:Adrenergic beta-Antagonists / Q000633:toxicity*; D000328:Adult; D002121:Calcium Channel Blockers / Q000633:toxicity*; D062787:Drug Overdose; D005217:Fat Emulsions, Intravenous / Q000627:therapeutic use*; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012770:Shock, Cardiogenic / Q000139:chemically induced / Q000628:therapy*; D055815:Young Adult
chemical_list: D000319:Adrenergic beta-Antagonists; D002121:Calcium Channel Blockers; D005217:Fat Emulsions, Intravenous
keywords: Intravenous lipid therapy; calcium channel blocker overdose; emergency, poisoning; β-blocker overdose