Use of Intravenous Lipid Emulsion Therapy and Insulin in a Case of Tarka Intoxication.

Tarka (trandolapril/verapamil hydrohloride extended-release) is a fixed-dose combination antihypertensive drug formed from verapamil hydrochloride and trandolapril. Toxicologic manifestations of Tarka overdose are altered mental status, bradycardia, hypotension, atrioventricular block (first-degree), hyperglycemia, metabolic acidosis, and shock. We report a case of Tarka toxicity in a 2-year-old girl who presented with altered mental status, cardiogenic shock, hypotension, bradycardia, severe metabolic acidosis, hyperglycemia, and first-degree atrioventricular block. We started fluid resuscitation, epinephrine, norepinephrine, and insulin. Because of the patient's hyperlactatemia and hypotension despite standard therapies, we initiated intravenous lipid emulsion (ILE) therapy, after which her condition improved promptly. Tarka overdose may be life-threatening as it can cause cardiogenic shock. In our patient, the regression of lactate elevation in a short time with ILE therapy and the improvement of her general condition highlight the importance of ILE. ILE is an alternative treatment method for acute lipophilic drug intoxications, such as Tarka. Copyright© Board of Regents of the University of Wisconsin System and The Medical College of Wisconsin, Inc.

Citation

Emrah Gün, Mahmut Çiçek, Mustafa Kafalı, Hüsnü Demir, İlknur Arslan, Tanıl Kendirli. Use of Intravenous Lipid Emulsion Therapy and Insulin in a Case of Tarka Intoxication. WMJ : official publication of the State Medical Society of Wisconsin. 2024 May;123(2):144-146

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PMID: 38718248

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