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10.1536/ihj.37.925 http://scihub22266oqcxt.onion/10.1536/ihj.37.925 9057687!ä!9057687 Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534 Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534       Jpn+Heart+J 1996 ; 37 (6): 925-31 Nephropedia Template TP {{tp|p=9057687|t=1996. Anticholinergic overdose induced torsade de pointes successfully treated with verapamil |pdf=|usr=}}{{9057687}} gab.com Text Anticholinergic overdose induced torsade de pointes successfully treated with verapamil JO: Jpn Heart J http://www.kidney.de/pget.php?&tw=1&pmid=9057687 #FOAvip An 18-year-old schizophrenic female was recently treated after overdosing on trihexyphenidyl, thioridazine and an unknown antidepressant. On presentation to a local hospital, she was cyanotic with dilatated pupils and in acute respiratory failure. She was intubated prior to transfer. While in our Emergency Department, she exhibited occasional premature ventricular contractions which later became intermittent torsade de pointes. As this was an anticholinergic overdose we infused sodium bicarbonate in an attempt to increase protein binding, hoping to decrease the concentration of toxic metabolites. We also tried to suppress the dysrhythmia by infusing magnesium. The potassium level was borderline low so a supplemental infusion was initiated. Defibrillation was attempted. To try to shorten the action potential duration by activating the K+ channel, an isuprel infusion was also attempted. All methods failed. The patient fluctuated between an irregular sinus rhythm with prolonged QT interval and pulseless torsade de pointes for almost 24 hours. At all times, she responded appropriately to pain. Finally we attempted blockade of the calcium channel using verapamil with dramatic results. Each single bolus (0.1 mg/kg) successfully converted the patient back to sinus rhythm for some 15-20 minutes before the torsade recurred. After the initiation of a continuous verapamil infusion (0.005 mg/kg/hr), the patient remained in stable sinus rhythm. Verapamil proved highly effective in this patient with an anticholinergic overdose induced dysrhythmia. Twit Text FOAVip Anticholinergic overdose induced torsade de pointes successfully treated with verapamil ????Jpn Heart J http://www.kidney.de/pget.php?&tw=1&pmid=9057687 #FOAvip Twit Text # Free Paper on # # # # # LINK http://www.kidney.de/pget.php?&tw=1&pmid=9057687 #FOAvip English Wikipedia <ref>{{Cite pmid|9057687}}</ref> Anticholinergic overdose induced torsade de pointes successfully treated with verapamil #MMPMID9057687 Liao WB; Bullard MJ; Kuo CT; Hsiao CT; Chu PH; Chiang CW Jpn Heart J 1996[Nov]; 37 (6): 925-31 PMID9057687show ga An 18-year-old schizophrenic female was recently treated after overdosing on trihexyphenidyl, thioridazine and an unknown antidepressant. On presentation to a local hospital, she was cyanotic with dilatated pupils and in acute respiratory failure. She was intubated prior to transfer. While in our Emergency Department, she exhibited occasional premature ventricular contractions which later became intermittent torsade de pointes. As this was an anticholinergic overdose we infused sodium bicarbonate in an attempt to increase protein binding, hoping to decrease the concentration of toxic metabolites. We also tried to suppress the dysrhythmia by infusing magnesium. The potassium level was borderline low so a supplemental infusion was initiated. Defibrillation was attempted. To try to shorten the action potential duration by activating the K+ channel, an isuprel infusion was also attempted. All methods failed. The patient fluctuated between an irregular sinus rhythm with prolonged QT interval and pulseless torsade de pointes for almost 24 hours. At all times, she responded appropriately to pain. Finally we attempted blockade of the calcium channel using verapamil with dramatic results. Each single bolus (0.1 mg/kg) successfully converted the patient back to sinus rhythm for some 15-20 minutes before the torsade recurred. After the initiation of a continuous verapamil infusion (0.005 mg/kg/hr), the patient remained in stable sinus rhythm. Verapamil proved highly effective in this patient with an anticholinergic overdose induced dysrhythmia. |Adolescent[MESH] |Antidepressive Agents/*adverse effects[MESH] |Antipsychotic Agents/*adverse effects[MESH] |Cholinergic Antagonists/*adverse effects[MESH] |Drug Overdose[MESH] |Female[MESH] |Humans[MESH] |Schizophrenia/*drug therapy[MESH] |Thioridazine/*adverse effects[MESH] |Torsades de Pointes/*chemically induced/*drug therapy[MESH] |Trihexyphenidyl/*adverse effects[MESH]Anticholinergic overdose induced torsade de pointes successfully treat(epmc).pdf DeepDyve Pubget Overpricing