{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T05:47:50Z","timestamp":1769752070568,"version":"3.49.0"},"reference-count":10,"publisher":"Walter de Gruyter GmbH","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,3,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    We report a case of an adult patient using chronic low-dose verapamil who developed severe verapamil intoxication. A 57-year-old male patient was presented at the emergency room after a collapse of unknown etiology. The airway was compromised, and thus, an endotracheal tube was inserted. The patient deteriorated hemodynamically. Because of verapamil use and bradycardia, verapamil intoxication was suspected. The treatment was supported with intravenous fluids, calcium, inotropes, and a transvenous pacemaker. The patient progressively developed circulatory shock. Verapamil intoxication was confirmed, and therapy was adjusted accordingly. Insulin and calcium infusion were intensified, and glucagon and Intralipid\n                    <jats:sup>\u00ae<\/jats:sup>\n                    infusion were initiated. With this therapy, the patient\u2019s condition improved rapidly. We found different factors in this patient that could have precipitated this event such as diminished metabolism by cytochrome P450 iso-enzymes, a slightly diminished renal function with hypoalbuminemia, and interaction with other protein-binding drugs.\n                  <\/jats:p>","DOI":"10.1515\/dmpt-2015-0041","type":"journal-article","created":{"date-parts":[[2016,2,23]],"date-time":"2016-02-23T12:01:12Z","timestamp":1456228872000},"page":"55-58","source":"Crossref","is-referenced-by-count":5,"title":["Severe verapamil intoxication despite correct use of low-dose verapamil"],"prefix":"10.1515","volume":"31","author":[{"given":"Loes","family":"Mandigers","sequence":"first","affiliation":[{"name":"Department of Intensive Care, St Elisabeth TweeSteden Hospital, Tilburg, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pauline D.J.","family":"Bollen","sequence":"additional","affiliation":[{"name":"Hospital Pharmacy Midden-Brabant, St Elisabeth TweeSteden Hospital, Tilburg, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Peter J.","family":"Bijlstra","sequence":"additional","affiliation":[{"name":"Department of Intensive Care, St Elisabeth TweeSteden Hospital, Tilburg, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Els","family":"Brands","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2016,2,23]]},"reference":[{"key":"2025121207024299276_j_dmpt-2015-0041_ref_001_w2aab2b8c22b1b7b1ab2ab1Aa","doi-asserted-by":"crossref","unstructured":"De Simona A, De Pasquale M, De Matteis C, Canciello M, Manzo M, Sabino L, et al. Verapamil plus antiarrhythmic drugs reduce atrial fibrillation recurrences after an electrical cardioversion (VEPARAF Study). Eur Hearts J 2003;24:1425.10.1016\/S0195-668X(03)00311-7","DOI":"10.1016\/S0195-668X(03)00311-7"},{"key":"2025121207024299276_j_dmpt-2015-0041_ref_002_w2aab2b8c22b1b7b1ab2ab2Aa","doi-asserted-by":"crossref","unstructured":"Candell J, Valle V, Soler M, Rius J. Acute intoxication with verapamil. Chest 1979;75:200\u20131.10.1378\/chest.75.2.200421559","DOI":"10.1378\/chest.75.2.200"},{"key":"2025121207024299276_j_dmpt-2015-0041_ref_003_w2aab2b8c22b1b7b1ab2ab3Aa","doi-asserted-by":"crossref","unstructured":"Sami Karti S, Ulusoy H, Yandi M, G\u00fcnd\u00fcz A, Ko\u015fucu M, Erol K, et al. Non cardiogenic pulmonary oedema in course of verapamil intoxication. Emerg Med 2002;19:458\u20139.10.1136\/emj.19.5.458","DOI":"10.1136\/emj.19.5.458"},{"key":"2025121207024299276_j_dmpt-2015-0041_ref_004_w2aab2b8c22b1b7b1ab2ab4Aa","unstructured":"Assink MA, Spronk PE, van Kan HJ, Braber A. Intravenous lipid emulsion in the treatment of verapamil intoxication. Neth J Crit Care 2013;17:18\u201321."},{"key":"2025121207024299276_j_dmpt-2015-0041_ref_005_w2aab2b8c22b1b7b1ab2ab5Aa","doi-asserted-by":"crossref","unstructured":"Rosser G, Dubrey SW. Massive calcium channel blocker overdose: intravenous insulin and glucose as a therapy. BMJ Case Rep 2012. 10.1136\/bcr.03.2012.6114.10.1136\/bcr.03.2012.6114454324122675147","DOI":"10.1136\/bcr.03.2012.6114"},{"key":"2025121207024299276_j_dmpt-2015-0041_ref_006_w2aab2b8c22b1b7b1ab2ab6Aa","doi-asserted-by":"crossref","unstructured":"French D, Armenian P, Ruan W, Wong A, Drasner K, Olson KR, et al. Serum verapamil concentration before and after Intralipid therapy during treatment of an overdose. Clin Toxicol 2011;49:340\u20134.10.3109\/15563650.2011.57255621563913","DOI":"10.3109\/15563650.2011.572556"},{"key":"2025121207024299276_j_dmpt-2015-0041_ref_007_w2aab2b8c22b1b7b1ab2ab7Aa","doi-asserted-by":"crossref","unstructured":"Busse D, Cosme J, Beaune P, Kroemer HK, Eichelbaum M. Cytochromes of the P4502C subfamily are the major enzymes involved in the O-demethylation of verapamil in humans. Naunyn-Schmiedeberg\u2019s Arch Pharmacol 1995;353:116\u201321.10.1007\/BF001689248750925","DOI":"10.1007\/BF00168924"},{"key":"2025121207024299276_j_dmpt-2015-0041_ref_008_w2aab2b8c22b1b7b1ab2ab8Aa","doi-asserted-by":"crossref","unstructured":"Roberts JA, Pea F, Lipman J. The clinical relevance of plasma protein binding changes. Clin Pharmacokinet 2013;52:1\u20138.10.1007\/s40262-012-0018-523150213","DOI":"10.1007\/s40262-012-0018-5"},{"key":"2025121207024299276_j_dmpt-2015-0041_ref_009_w2aab2b8c22b1b7b1ab2ab9Aa","unstructured":"Yong CL, Kunka RL, Bates TR. Factors affecting the plasma protein binding of verapamil and norverapamil in man. Res Commun Chem Pathol Pharmacol 1980;30:329\u201339."},{"key":"2025121207024299276_j_dmpt-2015-0041_ref_010_w2aab2b8c22b1b7b1ab2ac10Aa","doi-asserted-by":"crossref","unstructured":"Kishore K, Raina A, Misra V, Jonas E. Acute verapamil toxicity in a patient with chronic toxicity: possible interaction with ceftriaxone and clindamycin. Ann Pharmacother 1993;27:877\u201380.10.1177\/1060028093027007118364267","DOI":"10.1177\/106002809302700711"}],"container-title":["Drug Metabolism and Personalized Therapy"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/dmpt-2015-0041\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/dmpt-2015-0041\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,12]],"date-time":"2025-12-12T07:38:36Z","timestamp":1765525116000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/dmpt-2015-0041\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,2,23]]},"references-count":10,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2016,2,27]]},"published-print":{"date-parts":[[2016,3,1]]}},"alternative-id":["10.1515\/dmpt-2015-0041"],"URL":"https:\/\/doi.org\/10.1515\/dmpt-2015-0041","relation":{},"ISSN":["2363-8915","2363-8907"],"issn-type":[{"value":"2363-8915","type":"electronic"},{"value":"2363-8907","type":"print"}],"subject":[],"published":{"date-parts":[[2016,2,23]]}}}