title: Nifedipine poisoning in a child.
abstract: A 14-month-old child ingested approximately 800 mg (70 mg/kg) of nifedipine. When first examined, the child was unresponsive, markedly hypotensive, and hyperglycemic. According to electrocardiographic results, there was a third-degree atrioventricular block that rapidly progressed to cardiac arrest. Following successful cardiopulmonary resuscitation, mechanical ventilation and resuscitation with intravenous normal saline, calcium chloride and dopamine were required to restore perfusion, reverse metabolic acidosis, and stabilize vital signs. Complications related to nifedipine intoxication included the development of pulmonary edema and possible infarction in the posterior parietal and occipital lobes associated with cortical blindness and the development of seizures with an abnormal electroencephalogram. The patient recovered without clinically apparent residua. Massive nifedipine overdose in infants represents a potentially life-threatening event that requires prompt medical attention. Reported cases of nifedipine intoxication were reviewed and therapeutic interventions were discussed.
authors.affiliation: Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock.
authors.forename: T G
authors.initials: TG
authors.lastname: Wells
authors.forename: C J
authors.initials: CJ
authors.lastname: Graham
authors.forename: M M
authors.initials: MM
authors.lastname: Moss
authors.forename: G L
authors.initials: GL
authors.lastname: Kearns
mesh_terms: D001766:Blindness / Q000139:chemically induced; D003131:Combined Modality Therapy / Q000379:methods; D062787:Drug Overdose / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy; D004630:Emergencies; D005260:Female; D006327:Heart Block / Q000139:chemically induced / Q000175:diagnosis / Q000628:therapy; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D007223:Infant; D009543:Nifedipine / Q000506:poisoning*; D012151:Resuscitation / Q000379:methods; D012640:Seizures / Q000139:chemically induced / Q000175:diagnosis / Q000628:therapy
chemical_list: D009543:Nifedipine