Effect of levosimendan in experimental verapamil- induced myocardial depression
11.03.10
Calcium antagonist overdose can cause severe deterioration of hemodynamics unresponsible to treatment with beta adrenergic inotropes. The aim of the study was to evaluate in an experimental model the effects of levosimendan during severe calcium antagonist intoxication.
Methods: Twelve landrace-pigs were intoxicated with intravenous verapamil at escalating infusion rates.
The infusion containing 2.5mg/ml verapamil was used aiming to a reduction of cardiac output by 40% from the baseline value. Intoxicated pigs were randomized into two groups: control (saline) and levosimendan (intravenous bolus).
Inotropic effect was measured as a change in a maximum of the positive slope of the left ventricular pressure (LV dP/dt). The survival and hemodynamics of the animals were followed for 120 min after the targeted reduction of cardiac output.
Results: In the control group, five out of six pigs died during the experiment.
In the levosimendan group, one pig died
Source: 7thSpace Interactive (press release)
Jail staff gave lethal dose to Gurnee inmate
05.03.10
The son of a Gurnee man who died in Joliet last year has filed a federal lawsuit against Will County for allegedly administering a lethal dose of prescription drugs.
Darnell Wormley, the son of Frank Wormley, is seeking compensatory and punitive damages, plus the cost of the lawsuit.
The six-count suit claims Will County employees willfully and wantonly administered the lethal dose, failed to monitor Wormley and failed to timely administer medical attention.
On Oct. 28, 2009, the Will County Sheriff's Department took Frank Wormley into custody in Joliet and gave him a lethal dose of one or more prescription drugs, including Verapamil, according to the lawsuit filed Wednesday in U.S. District Court.
Wormley was arrested Oct. 28 for an outstanding warrant and was being held on $10,000 bond. He was in the jail's medical unit and arrived at the hospital just hours after he was scheduled to appear in court on charges of driving under the influence of alcohol in 2004, Will County Sheriff's spokesman Pat Barry said. Barry declined comment on the lawsuit.
Source: Waukegan News Sun
Calcium Channel Blockers May Interfere with Clopidogrel Response
11.03.10
On multivariable analysis that controlled for numerous drugs, baseline factors, and stent locations, calcium channel blocker use was the only independent predictor of reduced platelet inhibition on both LTA (
P = 0.006) and VerifyNow (
P = 0.004). Interestingly, proton pump inhibitor use, which previous studies have linked with poor clopidogrel response, was not found to be an independent predictor of high platelet reactivity (
P = 0.58 by LTA;
P = 0.77 by VerifyNow).
Patients taking calcium channel blockers were older (69 ± 10 vs. 64 ± 12 years; P = 0.04) and had higher rates of hypertension (100% vs. 90.8%; P = 0.02) and diabetes (50.9% vs. 25.7%; P = 0.001) than patients not taking the drugs. Patients taking calcium channel blockers also had higher rates of peripheral stenting (75.5% vs. 48.6%; P = 0.001) and lower rates of coronary stenting (15.1% vs. 41.3%; P = 0.001) and previous MI (17% vs. 46.8%; P < 0.001).
Source: TCTMD
Intravenous verapamil (10 mg given over 1 min) is an alternative if the patient has adequate blood pressure. These drugs may suppress triggered rhythms.