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CARDIOVASCULAR ANESTHESIOLOGY

Treatment of Serious Calcium Channel Blocker Overdose With Levosimendan, a Calcium Sensitizer

Tero Varpula, MD, PhD^*, Janne Rapola, MD, PhD, Marko Sallisalmi, MD, and Jouni Kurola, MD, PhD

From the *Department of Anesthesiology and Intensive Care Medicine, Jorvi Hospital, Helsinki University Hospital, Espoo, Finland; Department of Cardiology, Helsinki University Hospital, Helsinki, Finland; Department of Anesthesiology and Intensive Care Medicine, Helsinki University Hospital, Helsinki, Finland; and Intensive Care Unit, Kuopio University Hospital, Kuopio, Finland.

Address correspondence and reprint requests to Tero Varpula, MD, PhD, Department of Anesthesiology and Intensive Care Medicine, Jorvi Hospital, Turuntie 150, 02740 Espoo, Finland. Address e-mail to tero.varpula{at}hus.fi.

Abstract

Calcium channel blocker (CCB) overdose is often lethal. Conventional medical treatment includes IV calcium, high doses of catecholamines, insulin, and glucagon. A new inotropic drug, levosimendan, should be considered in severe CCB poisoning. Levosimendan’s pharmacologic features differ from other inotropic drugs. It is a calcium sensitizer and improves contraction without increasing intracytosolic calcium concentration. We describe two patients with serious CCB overdose. Despite intensive medical and mechanical cardiovascular support, both patients remained in shock. Hemodynamics gradually improved after administration of levosimendan.

This article has been cited by other articles:

				T. R. Espinoza, A. R. Mottram, and S. M. Bryant Levosimendan for Calcium Channel Blocker Poisoning in Humans Anesth. Analg., September 1, 2009; 109(3): 992 - 992. [Full Text] [PDF]