Uspešna primena intravenskih emulzija masti u terapiji akutnog trovanja verapamilom

  • Gordana N Vuković Ercegović Nacionalni centar za kontrolu trovanja, Klinika za urgentnu i kliničku toksikologiju, Vojnomedicinska akademija, Beograd
  • 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
Ključne reči: poisoning||, ||trovanje, suicide||, ||samoubistvo, verapamil||, ||verapamil, calcium channel blockers||, ||kalcijum, blokatori, heart block||, ||srce, blok, fat emulsions, intravenous||, ||masne emulzije, intravenske, treatment outcome||, ||lečenje, ishod,

Sažetak


Uvod. Poslednjih godina intravenske emulzije masti uspešno se koriste u terapiji akutnih trovanja lipofilnim supstancama, uključujući i verapamil. Prikaz bolesnika. Prikazana je 37-godišnja pacijentkinja primljena jedan sat nakon ingestije 2,8 g verapamila. Na prijemu je bila hipotenzivna, sa kompletnim srčanim blokom. Zbog izostanka efekta primenjene standardne terapije i daljeg pogoršanja stanja pacijentkinje primenjen je Intralipid® 20%, nakon čega je uspostavljen sinusni ritam. Zabeležen je porast arterijskog pritiska, uz smanjenje koncentracije verapamila, kako ukupnog, tako i slobodne frakcije leka. Zaključak. Intravenske emulzije masti mogu zauzeti važno mesto u terapiji teške akutne intoksikacije i kardiotoksičnosti uzrokovane verapamilom.

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Objavljeno
2017/06/21
Broj časopisa
Vol. 74 Br. 3 (2017)
Rubrika
Prikaz bolesnika