Successful usage of intravenous lipid emulsion in treatment of acute verapamil poisoning – A case report

Gordana N Vuković Ercegović; Nataša Perković Vukčević; Snežana Djordjević; Zoran Šegrt; Olivera Potrebić; Snežana R Janković; Jasmina Jović Stošić; Nadica Marinković

doi:10.2298/VSP150901010V

Gordana N Vuković Ercegović National Poison Control Center , Military Medical Academy, Belgrade
Nataša Perković Vukčević National Poison Control Center, Military Medical Academy, Belgrade, Serbia
Snežana Djordjević National Poison Control Center, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
Zoran Šegrt Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
Olivera Potrebić National Poison Control Center, ilitary Medical Academy, Belgrade, Serbia
Snežana R Janković Institute for Scientific Information, Military Medical Academy, Belgrade, Serbia
Jasmina Jović Stošić National Poison Control Center, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia
Nadica Marinković Institute of Pathology and Forensic Medicine, Military Medical Academy, Belgrade, Serbia; Faculty of Medicine of the Military Medical Academy, University of Defence, Belgrade, Serbia

DOI: https://doi.org/10.2298/VSP150901010V

Keywords: poisoning, suicide, verapamil, calcium channel blockers, heart block, fat emulsions, intravenous, treatment outcome,

Abstract

Introduction. During the last few years, intravenous lipid emulsions have been effectively used in treatment of acute poisonings with lipophilic substances, including verapamil. Case report. A 37-year-old women presented 1 hour after ingestion of 2.8 g verapamil with hypotension and complete heart block. Because of the applied standard therapy failure and further patients impairment, Intralipid^® 20% was used. Sinus rhythm was restored, arterial blood pressure increased and verapamile concentrations, both total and free decreased. Conclusion. Intravenous lipid emulsion can be important in treatment of severe acute intoxication and cardiotoxicity caused by verapamil.

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