Address reprint requests to Dr Horowitz: Division of Emergency Medicine/Clinical Toxicology, University of California, Davis, Medical Center, 2315 Stockton Blvd, Trailer 1219, Sacramento, CA 95817.
Address reprint requests to Dr Horowitz: Division of Emergency Medicine/Clinical Toxicology, University of California, Davis, Medical Center, 2315 Stockton Blvd, Trailer 1219, Sacramento, CA 95817.
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Abstract
This report describes two patients who were victims of massive verapamil ingestion and then reviews the available literature. Because verapamil blocks the slow calcium channels of the heart and blood vessels, the use of calcium as a treatment would be logical. In the two cases reported here, calcium was only transiently effective in maintaining cardiac output and blood pressure. Several other agents were then used and most were ineffective. This is similar to experience reported in the literature that suggests that no single agent is capable of reversing verapamil's negative inotropic, dromotropic, chronotropic, and vascular smooth muscle effects.
