nmpЖурнал им. Н.В. Склифосовского «Неотложная медицинская помощь»Russian Sklifosovsky Journal "Emergency Medical Care"2223-90222541-8017“N.V. Sklifosovsky Research Institute for Emergency Medicine”10.23934/2223-9022-2024-13-2-269-279nmp-1891Research ArticleОБЗОР ЛИТЕРАТУРЫREVIEWSСовременный взгляд на лечение острых отравлений блокаторами кальциевых каналовA Modern View on the Treatment for Acute Calcium Channel Blocker Poisoninghttps://orcid.org/0000-0003-4736-1068СимоноваА. Ю.SimonovaA. Yu.

Анастасия Юрьевна Симонова, кандидат медицинских наук, ведущий научный сотрудник, научный сотрудник, и. о. зав. кафедрой

Отделение острых отравлений и соматопсихиатрических расстройств; кафедра клинической токсикологии

129090; Большая Сухаревская пл., д. 3; 125993; ул. Баррикадная, д. 2/1, стр. 1; 119435; ул. Малая Пироговская, д. 1А; Москва 

Anastasia Yu. Simonova, Candidate of Medical Sciences, Leading Researcher, Acting Head of the Department

Department of Acute Poisoning and Somatopsychiatric Disorders; Department of Clinical Toxicology

129090; Bolshaya Sukharevskaya Sq. 3; 125993; 2/1 Barricadnaya str., building 1; 119435; Malaya Pirogovskaya Str. 1А; Moscow

simonovaau@sklif.mos.ruhttps://orcid.org/0000-0001-6137-8961ИльяшенкоК. К.IlyashenkoK. K.

Капиталина Константиновна Ильяшенко, доктор медицинских наук, профессор, научный консультант, ведущий научный сотрудник

Отделение острых отравлений и соматопсихиатрических расстройств

129090; Большая Сухаревская пл., д. 3; Москва

Kapitalina K. Ilyashenko, Doctor of Medical Sciences, Full Professor, Scientific Consultant, Leading Researcher

Department of Acute Poisoning and Somatopsychiatric Disorders

129090; Bolshaya Sukharevskaya Sq. 3; 119435; Malaya Pirogovskaya Str. 1А; Moscow

toxikapa@mail.ruhttps://orcid.org/0000-0003-0117-8663ПоцхверияМ. М.PotskhveriyaM. M.

Михаил Михайлович Поцхверия, доктор медицинских наук, заведующий отделением

Отделение острых отравлений и соматопсихиатрических расстройств

129090; Большая Сухаревская пл., д. 3; 125993; ул. Баррикадная, д. 2/1, стр. 1; Москва

Mikhail M. Potskhveriya, Doctor of Medical Sciences, Head at the Department, Professor

Department of Acute Poisoning and Somatopsychiatric Disorders; Department of Clinical Toxicology

129090; Bolshaya Sukharevskaya Sq. 3; 125993; 2/1 Barricadnaya str., building 1; Moscow

potskhveriya@mail.ruhttps://orcid.org/0000-0002-0861-5945БеловаМ. В.BelovaM. V.

Мария Владимировна Белова, доктор биологических наук, ведущий научный сотрудник, доцент

Отделение острых отравлений и соматопсихиатрических расстройств; кафедра клинической токсикологии

129090; Большая Сухаревская пл., д. 3; 125993; ул. Баррикадная, д. 2/1, стр. 1; Москва

Maria V. Belova, Doctor of Biological Sciences, Leading Researcher, Associate Professor, Department of Clinical Toxicology

Department of Acute Poisoning and Somatopsychiatric Disorders

129090; Bolshaya Sukharevskaya Sq. 3; 125993; 2/1 Barricadnaya str., building 1; Moscow

maniabel@gmail.comhttps://orcid.org/0009-0001-2334-7010АсановаЛ. Р.AsanovaL. R.

Лола Рустамовна Асанова, младший научный сотрудник

Отделение острых отравлений и соматопсихиатрических расстройств

129090; Большая Сухаревская пл., д. 3; Москва

Lola R. Asanova, Junior Researcher

Department of Acute Poisoning and Somatopsychiatric Disorders

129090; Bolshaya Sukharevskaya Sq. 3; Moscow

asanovasa@sklif.mos.ruГБУЗ «Научно-исследовательский институт скорой помощи им. Н.В. Склифосовского ДЗМ»; ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» МЗ РФ; ФГБУ «Федеральный научно-клинический центр физико-химической медицины им. Ю.М. Лопухина Федерального медико-биологического агентства России»РоссияN.V. Sklifosovsky Research Institute for Emergency Medicine; Scientific and Practical Toxicology Center of Federal Medical Biological Agency; Lopukhin Federal Research and Clinical Center of Physical-Chemical Medicine of the Federal Medical and Biological Agency of RussiaRussian FederationГБУЗ «Научно-исследовательский институт скорой помощи им. Н.В. Склифосовского ДЗМ»; ФГБУ «Федеральный научно-клинический центр физико-химической медицины им. Ю.М. Лопухина Федерального медико-биологического агентства России»РоссияN.V. Sklifosovsky Research Institute for Emergency Medicine; Lopukhin Federal Research and Clinical Center of Physical-Chemical Medicine of the Federal Medical and Biological Agency of RussiaRussian FederationГБУЗ «Научно-исследовательский институт скорой помощи им. Н.В. Склифосовского ДЗМ»; ФГБОУ ДПО «Российская медицинская академия непрерывного профессионального образования» МЗ РФРоссияN.V. Sklifosovsky Research Institute for Emergency Medicine; Scientific and Practical Toxicology Center of Federal Medical Biological AgencyRussian FederationГБУЗ «Научно-исследовательский институт скорой помощи им. Н.В. Склифосовского ДЗМ»РоссияN.V. Sklifosovsky Research Institute for Emergency MedicineRussian Federation202405092024132269279Copyright © Симонова А.Ю., Ильяшенко К.К., Поцхверия М.М., Белова М.В., Асанова Л.Р., 20242024Симонова А.Ю., Ильяшенко К.К., Поцхверия М.М., Белова М.В., Асанова Л.Р.Simonova A.Y., Ilyashenko K.K., Potskhveriya M.M., Belova M.V., Asanova L.R.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.jnmp.ru/jour/article/view/1891   ВВЕДЕНИЕ

   ВВЕДЕНИЕ. В начале XXI века изменилась структура острых экзотоксикозов, в частности, отмечено увеличение числа отравлений лекарственными средствами, влияющими преимущественно на сердечно-сосудистую систему, в том числе блокаторами кальциевых каналов. В настоящий момент нет четкого алгоритма лечения данной группы пациентов.

   ЦЕЛЬ

   ЦЕЛЬ. Оценить эффективность методов лечения острых отравлений блокаторами кальциевых каналов по данным литературы.

   МАТЕРИАЛ И МЕТОДЫ

   МАТЕРИАЛ И МЕТОДЫ. Поиск отечественных публикаций проводился в базе данных eLibrary, зарубежных — в базах MEDLINE/PubMed, Google Scholar за период 2010 — февраль 2022 годов, а также среди ранее опубликованных работ, которые не имеют современных аналогов. В качестве поискового запроса использовались термины согласно официальным терминам MeSH: "calcium channel blockers" OR "Blockers, Calcium Channel" OR "Calcium Channel Antagonists" AND "poisoning".

   РЕЗУЛЬТАТЫ

   РЕЗУЛЬТАТЫ. В данном обзоре приведены сведения о механизме действия, клинической картине, диагностике отравлений блокаторами кальциевых каналов, а также результатах применения различных методов лечения при данной патологии.

   ВЫВОДЫ

   ВЫВОДЫ. Обобщая полученные данные, можно схематично представить алгоритм лечения больных с острыми отравлениями блокаторами кальциевых каналов. После очищения желудочно-кишечного тракта и начала инфузионной терапии следует проводить патогенетическое лечение с применением препаратов кальция, в последующем при нестабильной гемодинамике показано назначение вазопрессоров и препаратов инотропного действия, и в случаях отсутствия положительной динамики подключать инсулинотерапию. Однако следует отметить, что такая схема носит ориентировочный характер, отражая узловые моменты. В целом указанная проблема остается открытой и требует проведения дальнейших многоцентровых исследований.

   BACKGROUND

   BACKGROUND. At the beginning of the 21st century, the structure of acute exotoxicoses changed, in particular, an increase in poisoning by drugs that mainly affect the cardiovascular system, including calcium channel blockers, was noted. Currently, there is no clear treatment algorithm for this group of patients.

   AIM OF STUDY

   AIM OF STUDY. To evaluate the effectiveness of methods for the treatment of acute calcium channel blocker (ССВ) poisoning according to the literature.

   MATERIAL AND METHODS

   MATERIAL AND METHODS. The search for domestic publications was carried out in the eLibrary database, foreign ones - in the MEDLINE/PubMed, Google Scholar databases for the period from 2010 to February 2022, as well as among previously published works that have no modern analogues. The terms used as a search query were according to the official MeSH terms: “calcium channel blockers” OR “Blockers, Calcium Channel” OR “Calcium Channel Antagonists” AND “poisoning”.

   RESULTS

   RESULTS. This review contains information about the mechanism of action, clinical picture, diagnosis of calcium channel blocker poisoning, as well as the results of using various methods of treatment for this pathology.

   CONCLUSIONS

   CONCLUSIONS. Summarizing the data obtained, it is possible to schematically present an algorithm for the treatment of patients with acute CCB poisoning. After cleansing the gastrointestinal tract and starting infusion therapy, pathogenetic treatment with the use of calcium preparations should be carried out, subsequently, in case of unstable hemodynamics, the prescription of vasopressors and inotropic drugs is indicated; and if there is no positive dynamics, insulin therapy must be added. However, it should be noted that such a scheme is indicative, reflecting the key points. In general, this problem remains open and requires further multicenter studies.

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The authors declare that there are no conflicts of interest present.