Prolonged Refractory Hypotension following Combined Amlodipine and Losartan Ingestion Responsive to Metaraminol

Autor: James O. M. Plumb, Craig Stewart, Michael Eddleston, Thearina de Beer
Jazyk: angličtina
Rok vydání: 2011
Předmět:
Zdroj: Case Reports in Medicine, Vol 2011 (2011)
Druh dokumentu: article
ISSN: 1687-9627
1687-9635
DOI: 10.1155/2011/283672
Popis: Introduction. Overdose with the calcium channel blocker amlodipine can cause profound hypotension that may be exacerbated by the concurrent ingestion of an angiotensin II receptor antagonist. Best management of such overdoses is uncertain although the use of hyperinsulinaemia-euglycaemia (HIE) has been recommended. Case report. We report a case of mixed amlodipine and losartan overdose in a 50-year-old lady. Severe hypotension was resistant to conventional vasopressors and high-dose insulin/euglycaemia, but did respond to a metaraminol infusion. Conclusion. A trial of metaraminol early in severe cases of calcium channel blocker and angiotensin II receptor antagonist toxicity may be of benefit, especially when conventional ionotropic treatment measures are failing.
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