The Journal of Emergency Medicine
Volume 38, Issue 2 , Pages 171-174, February 2010

Whole Bowel Irrigation and the Hemodynamically Unstable Calcium Channel Blocker Overdose: Primum Non Nocere

  • Kirk L. Cumpston, DO

      Affiliations

    • The Toxikon Consortium at Cook County Hospital, Chicago, Illinois
    • Department of Emergency Medicine, University of New Mexico, Albuquerque, New Mexico
    • ,
  • Steven E. Aks, DO

      Affiliations

    • The Toxikon Consortium at Cook County Hospital, Chicago, Illinois
    • Department of Emergency Medicine, Cook County Hospital, Chicago, Illinois
    • Corresponding Author InformationReprint Address: Steven E. Aks, do, facmt, Department of Emergency Medicine, Cook County Hospital, 1900 West Polk Street, 10th Floor, Chicago, IL 60612
    • ,
  • Todd Sigg, PHARMD

      Affiliations

    • The Illinois Poison Control Center, Chicago, Illinois
    • ,
  • Erin Pallasch, PHARMD

      Affiliations

    • The Illinois Poison Control Center, Chicago, Illinois

Received 30 August 2006; received in revised form 26 March 2007; accepted 15 November 2007. published online 10 July 2008.

Abstract 

Sustained-release calcium channel blocker (CCB SR) overdoses are potentially life-threatening ingestions. These patients may not become hemodynamically unstable until many hours after ingestion. On theoretical grounds, some have suggested that whole bowel irrigation (WBI) with polyethylene glycol electrolyte lavage solution may be of value in the management of these cases. We report two cases with poor outcome (including one fatality) that were complicated by the use of WBI. Both cases were treated with WBI beginning before and continuing after developing hypotension. WBI should be avoided in the setting of the hemodynamically unstable CCB SR overdose.

Keywords: calcium channel blocker, overdose, whole bowel irrigation, toxicity, complication

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PII: S0736-4679(08)00190-X

doi:10.1016/j.jemermed.2007.11.100

The Journal of Emergency Medicine
Volume 38, Issue 2 , Pages 171-174, February 2010

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