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Case Reports
. 2024 Aug 6;16(8):e66308.
doi: 10.7759/cureus.66308. eCollection 2024 Aug.

Single-Dose Calcium Channel Blocker Toxicity in a Patient With Severe Liver Disease

Shweta Lodha  1 , Daniel Loriaux  2 , Amanda L Faulkner  3 , Kathyrn Pearson  3 , Shreyansh Shah  4
Affiliations
Case Reports

Single-Dose Calcium Channel Blocker Toxicity in a Patient With Severe Liver Disease

Shweta Lodha et al. Cureus. .

Abstract

Calcium channel blockers (CCBs) are commonly used in the management of multiple diseases, including hypertension, arrhythmia, and vasospastic disorder. Nimodipine, a dihydropyridine CCB, has demonstrated utility in preserving hearing following vestibular schwannoma resection surgery. Due to its widespread use, CCB overdose is common. This case report presents a unique case of CCB toxicity in a 56-year-old female with end-stage liver dysfunction. The patient developed vasodilatory shock after receiving a single dose of prophylactic nimodipine following vestibular schwannoma surgery. The primary objective of this report is to highlight the unique risk for CCB toxicity that exists for patients with advanced liver disease who receive nimodipine in the perioperative setting.

Keywords: acoustic neuroma; acoustic neuroma resection; calcium channel blocker; calcium channel blocker toxicity; drug toxicity; nimodipine.

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Conflict of interest statement

Human subjects: Consent was obtained or waived by all participants in this study. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Progression of blood pressure and heart rate on hospital day 1
Trend lines show changes in the patient’s blood pressure and heart rate over the course of hospital day 1, and time points indicate when anesthetic agents, nimodipine, pressors, and calcium gluconate were initiated and/or weaned off.
Figure 2
Figure 2. Clinical and metabolic effects of calcium channel blocker toxicity
Image credits: Daniel Loriaux
See this image and copyright information in PMC

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