[논문]칼슘통로차단제 중독의 치료

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doi:10.22537/jksct.18.1.1

칼슘통로차단제 중독의 치료
Treatments of Calcium Channel Blocker Overdose 원문보기

대한임상독성학회지 = Journal of the Korean society of clinical toxicology, v.18 no.1, 2020년, pp.1 - 10

Abstract ▼ AI-Helper

Pharmaceutical agents are the most common causes of poisoning in Korea. Calcium channel blockers (CCBs) are commonly used in Korea for the management of hypertension and other cardiovascular diseases, but are associated with a risk of mortality due to overdose. Due to the frequent fatalities associated with CCB overdose, it is essential that the emergency physician is capable of identifying CCB intoxication, and has the knowledge to manage CCB overdose. This article reviews the existing clinical guidelines, retrospective studies, and systematic reviews on the emergency management of CCB overdose. The following are the varied treatments of CCB overdose currently administered. 1) For asymptomatic patients: observation with enough time and decontamination, if indicated. 2) For symptomatic patients: infusion of calcium salt, high dose insulin therapy, and vasopressor (norepinephrine) or atropine for bradycardia. 3) For patients refractory to the first line therapy or with refractory shock or impending arrest: lipid emulsion therapy and extracorporeal membrane oxygenation. 4) As adjunct therapy: phosphodiesterase inhibitors, glucagon, methylene blue, pacemaker for AV block. Small CCB ingestion is known to be fatal for pediatric patients. Hence, close observation for sufficient time is required.

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문제 정의

따라서, CCB 중독의 진단과 치료에 관한 많은 논문이 세계 각국에서 발표되고 있다. 본 원고에서는 그간 발표된 CCB 중독의 종설들을 중심으로 치료의 최신 지견을 정리해 보고, 특히 소아에서의 CCB중독과 CCB포함 복합제제 중독 치료의 특이점을 기술하고자 하였다.

제안 방법

대한임상독성학회지에서‘calcium channel blocker’를 검색하여 4개의 논문을 추출하여 연구에 활용하였고, 연구 자의 판단에 따라 6개의 논문을 추가로 추출하였다.
대한임상독성학회지에서‘calcium channel blocker’를 검색하여 4개의 논문을 추출하여 연구에 활용하였고, 연구 자의 판단에 따라 6개의 논문을 추가로 추출하였다. 총 35 개의 논문은 이 연구의 주요 세부 주제에 따라 CCB중독 일반적 특성과 치료^3-9,11-27), 소아CCB 중독의 특이점^10,28-34), CCB성분 포함 복합제제 중독의 특이점^35-37) 으로 분류하여 고찰에 주로 사용되었다.

대상 데이터

그 다음 PubMed 검색에서 ‘calcium channel blocker and pediatric’의 검색어로 full text 논문을 기간제한 없이 검색하였고, 그 결과 34개의 논문이 검색되었고, 이중 4개의 논문이 이 연구에 활용되었다.
문헌검색을 위해 PubMed에서 일차적으로‘calcium channel blocker poisoning’의 키워드와 최근 10년간, 문헌의 종류를 ‘Review’로 설정하여 검색한 결과 총 156 개의 논문이 검색되었고, 이 중 연구목적에 맞는 21개의 논문을 선정하였다.

참고문헌 (40)

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