Why the study?
Verapamil usage is limited by undesirable hypotension, particularly in vulnerable patients, while the role of intravenous calcium in reversing this in end-stage renal failure requires description.
Does intravenous calcium reverse verapamil-induced hypotension in a patient with end-stage renal failure?
Does intravenous calcium reverse verapamil-induced hypotension in a patient with end-stage renal failure?
Intravenous calcium can safely reverse verapamil-induced hypotension in patients with end-stage renal disease without compromising its antiarrhythmic efficacy.
May warrant consideration for verapamil-induced hypotension in ESRD; leaves open need for prospective confirmation.
Verapamil is a useful drug in supraventricular tachycardias, atrial flutters, and fibrillations. However, its usage is accompanied by an undesirable side effect of hypotension. This limits its usage in patients where even the slightest reduction of blood pressure for a brief period may prove detrimental, e.g., in patients with critical coronary artery disease. Intravenous calcium given as pretreatment to verapamil prevented verapamil-induced hypotension. Its usage after hypotension restored the blood pressure to its baseline level. All these occur without the loss of the antiarrhythmic effect of verapamil. Furthermore, the pharmacokinetics of verapamil is unaltered in patients with chronic kidney disease. Thus, no dosage adjustment is required in this population. Here we describe a case of verapamil-induced hypotension in a patient with end-stage renal failure, which was reverted with intravenous calcium administration without altering the atrioventricular blockade effect of verapamil.
No takes yet. Share an insight, caveat, or question.
Kaisbain et al. (2023) studied this question.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: