%PDF-1.3 %âãÏÓ 1 0 obj << /OPM 1 /Type/ExtGState >> endobj 2 0 obj << /FL 1 /SM 0.01 /Type/ExtGState >> endobj 3 0 obj << /Length 11117 >> stream /GS0 gs q 0 0.89 595 841 re W n 1 g 0 841.89 0 0 re f Q /GS1 gs q 0 0 0 0 k 56.693 138.898 481.89 494.551 re f Q q BT /F0 1 Tf 9 0 0 9 146.5879 625.7365 Tm 0 Tr 0 0 0 1 k 0 Tc 0 Tw (SUMMARY )Tj -2.55493 -2.22222 TD (Intoxication of diltiazem)Tj ET Q q BT /F1 1 Tf 9 0 0 9 57.6929 585.7366 Tm 0 Tr 0 0 0 1 k -0.0001 Tc (I)Tj 0.33292 0.00001 TD 0 Tc 0.044 Tw (ntoxications of calcium channel blocker which is used in lots)Tj -0.33292 -1.11112 TD 0.01 Tc 0.115 Tw (of conditions such as hypertension, supraventriculer arrhy-)Tj T* 0.014 Tc 0.111 Tw (thmias, angina pectoris; are more fatal than other cardiac)Tj 0 -1.11111 TD 0 Tc 0.125 Tw (drugs. In this study, we aimed to review the intoxications of)Tj 0 -1.11112 TD 0.034 Tw (calcium channel blockers because of a case. 34 years old ma-)Tj 0 -1.11111 TD 0.112 Tw (le case was brought to emergency un\335t, after three hours ta-)Tj T* 0.125 Tw (king 120 diltiazem tablets( each of them is 60 miligram) for)Tj 0 -1.11112 TD 0.062 Tw (suicide. Acut renal failure occured after 24 hours in the pati-)Tj T* 0.098 Tw (ent having complete atrioventriculer block at the beginning .)Tj 0 -1.11111 TD 0.007 Tc 0.118 Tw (Cardiac rythm of the patient was normal in 27th hour. The)Tj T* 0.014 Tc 0.111 Tw (patient who was taken hemodylasis twice in coronary care)Tj T* 0 Tc 0.029 Tw (unit, was transported to the internal medicine service because)Tj T* 0.01 Tw (of renal failure. Vasodilatation that occured because of the ef)Tj 24.75298 0 TD (-)Tj -24.75298 -1.11112 TD 0.014 Tw (fects in smooth muscle cells in calcium channel blockers over-)Tj 0 -1.11111 TD 0.102 Tw (dose, gives rise to decreasing in cardiac output, hypotension)Tj T* 0.125 Tw (and shock. Decreasing in organ perfusion can be concluded)Tj T* 0.016 Tw (with multi-organ disfunction. We wanted to point because of a)Tj T* 0.049 Tw (case developing complete atrioventriculer block and renal fa)Tj 24.75297 0 TD (-)Tj -24.75297 -1.11111 TD 0.091 Tw (ilure, intoxications of calcium channel blocker is a condition)Tj T* 0.004 Tc 0.121 Tw (having high mortality and morbidity, and it must be treated)Tj T* 0 Tc 0 Tw (fastly and aggresively.)Tj ET Q q BT /F2 1 Tf 9 0 0 9 57.6929 365.7365 Tm 0 Tr 0 0 0 1 k 0 Tc 0.101 Tw (Key words:)Tj ET Q q BT /F1 1 Tf 9 0 0 9 102.9947 365.7365 Tm 0 Tr 0 0 0 1 k 0 Tc 0.101 Tw (Intoxications of calcium channel blocker, morta-)Tj -5.03353 -1.11111 TD 0 Tw (lity, morbidity)Tj ET Q q BT /F2 1 Tf 9 0 0 9 57.6929 335.7365 Tm 0 Tr 0 0 0 1 k 0.03 Tc 0.095 Tw (Anahtar kelimeler:)Tj ET Q q BT /F1 1 Tf 9 0 0 9 137.5097 335.7365 Tm 0 Tr 0 0 0 1 k 0.03 Tc 0.095 Tw (Kalsiyum kanal blokeri zehirlenmesi,)Tj -8.86853 -1.11111 TD 0 Tc 0 Tw (mortalite, morbidite )Tj ET Q q BT /F0 1 Tf 10 0 0 10 57.6929 286.7365 Tm 0 Tr 0 0 0 1 k 0 Tc 0 Tw (OLGU )Tj ET Q q BT /F3 1 Tf 9 0 0 9 57.6929 263.7365 Tm 0 Tr 0 0 0 1 k 0 Tc 0.007 Tw (34 ya\337\335nde erkek hasta; intihar ama\215l\335 120 adet 60 miligraml\335k)Tj 0 -1.11111 TD 0.02 Tc 0.105 Tw (diltiazem tablet ald\335ktan 3 saat sonra acil servise getirildi.)Tj T* 0 Tc 0.005 Tw (Hasta acil serviste g\232r\237ld\237\333\237nde genel durum orta, \337uuru a\215\335k,)Tj T* 0.091 Tw (koopere, oryanteydi. Kan bas\335nc\335 60/45 mmHg, S1 S2 ritmik)Tj T* 0.081 Tw (bradikardik, kalp tepe at\335m\335 42 )Tj 12.95765 0 TD 0 Tw (at\335m)Tj 1.77735 0.00001 TD (/d)Tj 0.77783 0.00001 TD (k)Tj 0.83128 0.00001 TD 0.081 Tw (idi. Di\333er sistem mu)Tj 8.40887 0.00001 TD (-)Tj -24.75298 -1.11115 TD 0.038 Tw (ayeneleri ola\333and\335. Hastaya acil serviste nazogastrik sonda ta)Tj 24.75299 0.00001 TD (-)Tj -24.75299 -1.11112 TD 0.015 Tw (k\335larak mide lavaj\335 yap\335ld\335 ve aktif k\232m\237r uyguland\335. Hastan\335n)Tj 0 -1.11111 TD 0.072 Tw (elektrokardiyografisinde (EKG), tam AV blok saptand\335. Acil-)Tj T* 0.093 Tw (de bak\335lan ilk laboratuvar tahlillerinde patolojik bulgu yoktu.)Tj 0 -1.11111 TD 0.017 Tc 0.108 Tw (Hasta KYB\206\325ne al\335nd\335. Hemen 5 mikrogram/kg/dakikadan)Tj 0 -1.11111 TD 0 Tc 0.008 Tw (dopamin ve dobutamin perf\237zyonu ba\337land\335. 24 saatte 2500 cc)Tj 0.0006 Tc (%)' 1.20852 0 Td 0.001 Tc 0.124 Tw (0.9 NaCl olacak \337ekilde s\335v\335 replasman\335 yap\335ld\335. Hastan\335n)Tj -1.20852 -1.11111 TD 0 Tc 0.095 Tw (24 saatlik idrar \215\335k\335\337\335 150 cc oldu. Kan bas\335nc\335 80/50 mmHg)Tj 28.23535 53.51844 TD 0.004 Tc 0.121 Tw [(civar\335nda seyretti. Kontrol biyokimyasal testlerinde;)-375(\237re 127)]TJ 0 -1.11111 TD 0 Tc 0.057 Tw (mg/ dl, kreatinin 2,7 mg/dl saptand\335. Elektrolit seviyeleri nor-)Tj T* 0.093 Tw (maldi. Takiplerde \237re, kreatinin de\333erlerinde art\335\337 olmas\335, id-)Tj -0.0001 Tc (r)' 0.33289 0.00001 TD 0 Tc 0.109 Tw (ar \215\335k\335\337\335n\335n artmamas\335 \237zerine nefrolojiyle kons\237lte edilerek)Tj -0.33289 -1.11111 TD -0.0001 Tc (h)Tj 0.49991 0.00001 TD 0 Tc 0.088 Tw (asta hemodiyalize al\335nd\335. Hastan\335n kalp ritmi 27. saatte nor-)Tj -0.49991 -1.11112 TD 0.036 Tw (mal sin\237s ritmine d\232nd\237. KYB\206\325de toplam iki kez hemodiya-)Tj T* 0.057 Tw (lize giren hasta, takiplerde herhangi bir kardiyak problemi ol-)Tj 0 -1.11111 TD 0.04 Tw (mamas\335 \237zerine akut b\232brek yetersizli\333i a\215\335s\335ndan takip ve te-)Tj 0 -1.11112 TD 0 Tw (davi i\215in dahiliye servisine verildi.)Tj ET Q q BT /F0 1 Tf 10 0 0 10 311.811 519.4026 Tm 0 Tr 0 0 0 1 k 0 Tc 0 Tw (TARTI\336MA)Tj ET Q q BT /F3 1 Tf 10 0 0 10 311.811 493.4025 Tm 0 Tr 0 0 0 1 k 0 Tc 0.124 Tw [(Klinikte hipertansiyon, supraventrik\237ler ta\337ikardi, anj)-1(i-)]TJ 0 -1.3 TD 0.051 Tw (na pe)Tj 2.18856 0 TD (k)Tj 0.5 0 TD (toris gibi pek\215ok durumun tedavisinde kullan\335lan)Tj -2.68856 -1.30001 TD 0.009 Tc 0.116 Tw (kalsiyum kanal bloker (KKB)\325leri olan zehirlenmeler,)Tj 0 -1.3 TD 0 Tc 0.035 Tw (di\333er kardiyovask\237ler ila\215larla olan zehirlenmelere g\232re)Tj T* (daha \232l\237mc\237l seyreder)Tj ET Q q BT /F3 1 Tf 8 0 0 8 405.8649 444.0425 Tm 0 Tr 0 0 0 1 k 0 Tc 0 Tw ((1))Tj ET Q q BT /F3 1 Tf 10 0 0 10 415.1891 441.4026 Tm 0 Tr 0 0 0 1 k -0.0001 Tc (.)Tj 0.53458 0 Td 0 Tc 0.035 Tw (KKB\325leri hipertansiyon, ritm)Tj -10.87239 -1.3 TD 0.024 Tc 0.1 Tw [(bozukluklar\335, stabil anj)-1(ina pektoris, subaraknoid he-)]TJ T* 0 Tc 0.004 Tw (moraji, migren ve )Tj 7.3989 0 TD (R)Tj 0.667 0 TD (eynaud fenomeni gibi pek\215ok hasta)Tj 14.17851 0 TD (-)Tj -22.24441 -1.30001 TD 0.106 Tw (l\335\333\335n tedavisinde kullan\335l\335r. KKB\325leri karaci\333erde inak)Tj 22.24441 0 TD (-)Tj -22.24441 -1.3 TD 0.014 Tc 0.111 Tw (tif metabolitlerine metabolize edilir )Tj ET Q q BT /F3 1 Tf 8 0 0 8 465.8781 392.0425 Tm 0 Tr 0 0 0 1 k 0.014 Tc 0 Tw ((2))Tj ET Q q BT /F3 1 Tf 10 0 0 10 475.533 389.4025 Tm 0 Tr 0 0 0 1 k 0.0137 Tc (.)Tj 0.63854 0 Td 0.014 Tc 0 Tw (Aktivitelerini)Tj -17.01074 -1.3 TD 0 Tc 0.025 Tw [(birincil)-275(olarak kalpte ve d\237z kas h\237crelerinde bulunan L)]TJ T* 0.056 Tw (tipi kalsiyum kanallar\335nda, kalsiyumun h\237cre i\215ine giri)Tj 22.2444 0.00001 TD (-)Tj -22.2444 -1.30001 TD 0.098 Tw [(\337ini engelleyerek g\232sterir. Bu da,)-348(periferik)-348(vazodilatas-)]TJ 0 -1.3 TD 0.011 Tc 0.114 Tw (yon, sin\237s )Tj 4.65399 0.00001 TD 0 Tw <649FDB9F6D9F>Tj 3.71839 0.00001 TD 0.114 Tw (depresyonu, AV iletide bozukluk,)Tj -8.37238 -1.30001 TD 0.007 Tc 0.118 Tw [(miyokardda negatif inotropik etki)-375(ve)-375(dola\337\335m kollaps\335)]TJ 0 -1.3 TD 0 Tc 0.088 Tw (olmas\335na neden olur )Tj ET Q q BT /F3 1 Tf 8 0 0 8 398.0267 314.0425 Tm 0 Tr 0 0 0 1 k 0 Tc 0 Tw ((3))Tj ET Q q BT /F3 1 Tf 10 0 0 10 407.3509 311.4025 Tm 0 Tr 0 0 0 1 k -0.0001 Tc (.)Tj 0.58759 0 Td (L)Tj 0.94859 0 Td 0 Tc 0.088 Tw (tipi KKB a\337\335r\335 dozunda, v\237-)Tj -11.09016 -1.3 TD 0.023 Tw (cudun di\333er organlar\335nda bulunan kalsiyum kanallar\335n\335n)Tj T* 0.019 Tw (blokaj\335na ba\333l\335 olarak ayr\335ca mental bozukluklar, bulan-)Tj T* 0.069 Tw (t\335, kusma, hiperglisemiyle birlikte metabolik asidoz g\232-)Tj T* 0 Tw (r\237lebilir )Tj ET Q q BT /F3 1 Tf 8 0 0 8 346.7435 262.0426 Tm 0 Tr 0 0 0 1 k 0 Tc 0 Tw ((4))Tj ET Q q BT /F3 1 Tf 10 0 0 10 356.0678 259.4026 Tm 0 Tr 0 0 0 1 k 0 Tc (.)Tj 0.52249 0 Td 0 Tw (KKB )Tj 2.38344 0.00001 TD 0.023 Tw (a\337\335r\335 dozunu takiben ortaya \215\335kan tok-)Tj -7.33161 -1.30001 TD 0.014 Tc 0.111 Tw (sisite, ilac\335n ter)Tj 6.55371 0 TD 0 Tc (a)Tj 0.45778 0.00001 TD 0.014 Tc (p\232tik etkilerinin art\335\337\335 ve uzamas\335yla)Tj -7.01149 -1.30002 TD 0 Tc 0.125 Tw (karakterizedir. A\337\335r\335 doz durumlar\335nda kardiyovask\237ler)Tj 0 -1.3 TD 0.001 Tc 0.124 Tw (selektivite azal\335r )Tj ET Q q BT /F3 1 Tf 8 0 0 8 382.7976 223.0426 Tm 0 Tr 0 0 0 1 k 0.001 Tc 0 Tw ((4,5))Tj ET Q q BT /F3 1 Tf 10 0 0 10 398.1667 220.4026 Tm 0 Tr 0 0 0 1 k 0.001 Tc (.)Tj 0.62595 0 Td 0.124 Tw (Vask\237ler d\237z kas h\237crelerindeki)Tj -9.26151 -1.3 TD 0.013 Tc 0.112 Tw [(etkileriyle olu\337an vazodilatasyon,)-375(hipotansiyon, siste-)]TJ T* 0 Tc 0.015 Tw (mik vask\237ler diren\215te azalma ve \337oka neden olur. Nega-)Tj 0.0255 Tc (tif)' 1.34039 0 Td 0.025 Tc 0.099 Tw (inotropik ve kronotropik etki de kardiyak debide)Tj -1.34039 -1.3 TD 0 Tc 0.051 Tw (azalmaya, hipotansiyon ve \337oka neden olur. Miyokardi-)Tj T* 0.014 Tw [(yal iletide bozulma, sin\237s h\335z\335nda depresyon)-264(ve AV ileti)]TJ T* 0.123 Tw (bozukluklar\335na neden olur )Tj ET Q q BT /F3 1 Tf 8 0 0 8 422.9523 145.0426 Tm 0 Tr 0 0 0 1 k 0 Tc 0 Tw ((6))Tj ET Q q BT /F3 1 Tf 10 0 0 10 432.2765 142.4026 Tm 0 Tr 0 0 0 1 k -0.0001 Tc (.)Tj 0.62248 0 Td 0 Tc 0.123 Tw (KKB\325lerinin a\337\335r\335 dozda)Tj ET 0 0 0 0 k 56.693 655.796 481.89 72.708 re f Q q BT /F0 1 Tf 20 0 0 20 57.6929 712.5873 Tm 0 Tr 0 0 0 1 k 0 Tc 0 Tw (Diltiazem intoksikasyonu)Tj ET Q q BT /F0 1 Tf 10 0 0 10 57.6929 660.5873 Tm 0 Tr 0 0 0 1 k 0 Tc 0 Tw (Fatma AL\334BAZ-\205NER (*), Zeynep G\206RCAN (*), Selen YURDAKUL (**), Mecdi ERG\206NEY (***))Tj ET 0 J 0 j 10 M []0 d 1 w 0 0 0 1 K 56.693 646.788 m 538.583 646.788 l S 0 0 0 0 k 56.693 119.055 481.89 10.174 re f Q q BT /F3 1 Tf 8 0 0 8 57.6929 121.9651 Tm 0 Tr 0 0 0 1 k 0 Tc 0 Tw (SB \334stanbul E\333itim ve Ara\337t\335rma Hastanesi Dahiliye Klini\333i Asistan\335*; Kardiyoloji Uzman\335**; 2. Dahiliye Klini\333i \336efi***)Tj ET 0 J 0 j 10 M []0 d 1 w 0 0 0 1 K 56.693 133.229 m 538.583 133.229 l S 57.78 755.355 m 539.669 755.355 l S 0 0 0 0 k 56.693 752.851 481.89 13 re f Q q BT /F0 1 Tf 10 0 0 10 57.6929 757.021 Tm 0 Tr 0 0 0 1 k 0.1 Tc 0 Tw (OLGU SUNUMU)Tj ET Q q BT /F3 1 Tf 10 0 2.12557 10 463.1927 757.021 Tm 0 Tr 0 0 0 1 k 0.1 Tc 0 Tw (\334\215 Hastal\335klar\335 )Tj ET 0 J 0 j 10 M []0 d 1 w 0 0 0 1 K 56.693 748.351 m 538.583 748.351 l S 56.693 771.024 m 538.583 771.024 l S 56.693 314.646 m 283.464 314.646 l S 0 0 0 0 k 56.693 789.197 127.724 10.173 re f Q q BT /F1 1 Tf 8 0 0 8 57.6929 792.4114 Tm 0 Tr 0 0 0 1 k 0 Tc 0 Tw (G\232ztepe T\335p Dergisi 22(1):28-29, 2008)Tj ET 0 0 0 0 k 56.693 92.544 12.338 12.338 re f Q q BT /F0 1 Tf 10 0 0 10 57.6929 96.4236 Tm 0 Tr 0 0 0 1 k 0 Tc 0 Tw (28)Tj ET 0 0 0 0 k 470.551 788.1971 68.027 11.1729 re f Q q BT /F0 1 Tf 9 0 0 9 471.551 791.6577 Tm 0 Tr 0 0 0 1 k 0 Tc 0 Tw (ISSN 1300-526X)Tj ET Q endstream endobj 4 0 obj << /Length 6674 >> stream /GS0 gs q 0 0.89 595 841 re W n 1 g 0 841.89 0 0 re f Q /GS1 gs q 0 0 0 0 k 56.693 443.0551 481.89 313.796 re f Q q BT /F3 1 Tf 10 0 0 10 57.6929 748.021 Tm 0 Tr 0 0 0 1 k -0.0001 Tc (a)Tj 0.4439 0.00001 TD 0 Tc 0.025 Tw (l\335nmas\335na ba\333l\335 etkiler ila\215 al\335m\335ndan sonra 6 saat i\215in-)Tj -0.4439 -1.30001 TD -0.0001 Tc (de)Tj 1.21282 0 Td 0 Tc 0.019 Tw (ortaya \215\335kar. Beyin perf\237zyonunun bozulmas\335na ba\333-)Tj -1.21282 -1.3 TD -0.0001 Tc (l)Tj 0.27792 0.00001 TD