| disease | Diltiazem Toxicity |
| summary | Diltiazem toxicity is a potentially serious adverse effect of the calcium channel blocker diltiazem, characterized by a range of symptoms and signs that can affect multiple organ systems. It is an adverse drug reaction, not a disease in the traditional sense. Management involves discontinuing the medication, providing supportive care, and, in severe cases, utilizing specific treatments to counteract the effects of the toxicity. |
| name | Diltiazem Toxicity |
| type | Adverse Drug Reaction |
| classification | Cardiovascular/Pharmacological |
| symptoms | | 1 | Bradycardia (slow heart rate) | | 2 | Hypotension (low blood pressure) | | 3 | Atrioventricular block (AV block) | | 4 | Heart failure | | 5 | Lightheadedness | | 6 | Dizziness | | 7 | Confusion | | 8 | Nausea | | 9 | Vomiting | | 10 | Constipation | | 11 | Muscle weakness | | 12 | Respiratory depression | | 13 | Seizures | | 14 | Coma |
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| signs | | 1 | Hypotensive shock | | 2 | Arrhythmias (irregular heartbeats) | | 3 | Dyspnea (shortness of breath) | | 4 | Cyanosis (bluish discoloration of skin) | | 5 | Decreased level of consciousness |
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| causes | Overdose or excessive administration of diltiazem, often resulting in blood concentrations exceeding the therapeutic range. |
| detailed etiology pathogenesis | Diltiazem, a calcium channel blocker, inhibits calcium influx into heart muscle cells and other smooth muscle cells. Toxicity occurs when the drug's concentration surpasses the therapeutic threshold, leading to excessive calcium channel blockage. This can cause slowed heart rate, reduced blood pressure, and disruptions in heart electrical conduction. The severity of toxicity correlates with the blood concentration of diltiazem, as well as pre-existing health conditions and concomitant medications. |
| investigations | | 1 | Blood pressure measurement | | 2 | Heart rate monitoring | | 3 | Electrocardiogram (ECG) | | 4 | Blood tests (serum diltiazem levels, electrolytes, renal function, liver function) | | 5 | Cardiac enzyme levels (if suspected cardiac damage) |
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| treatment options | | 1 | Discontinuation of diltiazem | | 2 | Supportive care (intravenous fluids, maintaining blood pressure and oxygenation) | | 3 | Atropine (for bradycardia) | | 4 | Dopamine or norepinephrine (for hypotension) | | 5 | Pacemaker support (severe bradycardia or AV block) | | 6 | Gastric lavage (recent ingestion) | | 7 | Activated charcoal (to absorb remaining drug) | | 8 | Specific antidotes (rare, severe cases) |
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| differentials | | 1 | Other cardiovascular disorders | | 2 | Other medications | | 3 | Electrolyte imbalances | | 4 | Underlying medical conditions causing similar symptoms |
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| prevention | Adherence to prescribed dosages and close monitoring by healthcare professionals. Avoiding excessive doses or interactions with other medications. |
| prognosis | The prognosis depends on toxicity severity, promptness of diagnosis and treatment, and presence of pre-existing conditions. Mild cases typically respond well to supportive care. Severe cases can lead to potentially life-threatening complications, including cardiac arrest and death. |
| other important details | Self-treating diltiazem toxicity is strongly discouraged. Prompt medical intervention is crucial for effective management. |
