Hyperinsulin Therapy for Calcium Channel Antagonist Poisoning
| Autor: | Sean M. Bryant, Steve E. Aks, Tamara R. Espinoza |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Adult
Adolescent medicine.medical_treatment Antidotes Hypoglycemia Drug Administration Schedule Young Adult medicine Humans Insulin Pharmacology (medical) Young adult Infusions Intravenous Antidote Adverse effect Aged Retrospective Studies Aged 80 and over Pharmacology business.industry Poisoning Antagonist Retrospective cohort study General Medicine Middle Aged Calcium Channel Blockers medicine.disease Treatment Outcome Blood pressure Anesthesia Injections Intravenous Population study business |
| Zdroj: | American Journal of Therapeutics. 20:29-31 |
| ISSN: | 1075-2765 |
| DOI: | 10.1097/mjt.0b013e31824d5fbd |
| Popis: | The use of hyperinsulin therapy (HIT) in severe calcium channel antagonist (CCA) poisoning has become a more common therapy within the last decade. The objective of this study is to report 7 years of experience recommending HIT. This was a retrospective chart review utilizing our regional poison center (RPC) data from January 1, 2002, through December 31, 2008. All cases of CCA poisoning receiving HIT were searched. Endpoints included the number of CCA cases utilizing HIT, insulin dose, time of initiation of HIT, patient outcome, adverse events, age, glucose concentration, and lowest systolic blood pressure recorded. Forty-six cases of CCA poisoning were managed with HIT over 7 years. All the patients received standard antidotal therapy (= intravenous fluids, calcium salts, glucagon, and pressors). HIT administration followed our RPC recommendation 23 times (50%), and no hypoglycemic events occurred. Means (age, highest glucose measured, and lowest systolic blood pressure measured) were 51 years, 282 mg/dL, and 74 mm Hg, respectively. Our RPC recommendations for HIT were followed 50% of the time over the last 7 years. In light of the lack of hypoglycemia associated with HIT in our study population, we recommend HIT as an early and safe antidote in significant CCA poisoning. |
| Databáze: | OpenAIRE |
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