Kalsiyum Kanal Bloker İntoksikasyonunda Yoğun Bakım Yönetimi
Özet
Kalsiyum kanal blokerleri, toplumda yaygın olarak reçete edilen kardiyovasküler ilaçlar arasında önemli bir grubu oluşturur. Bu ilaçların kolay erişilebilir olması nedeniyle özkıyım amaçlı yüksek doz alımlarıyla veya reçeteli kullanımlarda doz aşımıyla acil servislerde sıklıkla rastlanmaktadır. Yüksek doz alımı sonrasında tedaviye dirençli hipotansiyon, şok, bradiaritmiler ve çoklu organ yetmezliği nedeniyle potansiyel olarak hayatı tehdit eden bir tabloya sebep olabilir. Erken tanı ve güncel tedavi yaklaşımları ile agresif bir tedavi hayat kurtarabilir. Bu bölümde özkıyım amacıyla yüksek doz diltiazem alımı sonrası acil servise geç başvuran 35 yaşındaki bir erkek olgu sunulmaktadır. Hastaneye geç başvuran ve ciddi diltiazem intoksikasyonu nedeniyle dirençli şok tablosu gelişen bu olgunun yoğun bakım yönetimini, tanıdan tedaviye kadar uzanan ayrıntılarıyla ele alarak klinisyenlere pratik ve rehber bir yaklaşım sunmak amaçlanmıştır.
Calcium channel blockers are a commonly prescribed class of cardiovascular drugs, and their wide availability makes both intentional overdoses and dosing errors relatively frequent presentations in emergency departments. Severe overdose may result in life-threatening complications such as refractory hypotension, shock, bradyarrhythmias, and multiple organ failure. Prompt recognition and aggressive, evidence-based management are critical to improving outcomes. This chapter presents the case of a 35years old male with delayed hospital admission following intentional ingestion of a massive dose of diltiazem, leading to refractory shock. The case is discussed in detail, focusing on the diagnostic process and intensive care management, with the aim of providing clinicians with a practical and structured approach to severe calcium channel blocker intoxication.
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