title: Captopril overdose resulting in hypotension.
abstract: We present a case in which a patient took an overdose of captopril (Capoten) and alprazolam (Xanax) in a suicide attempt. The patient presented with hypotension (systolic blood pressure of 80 mm Hg) and drowsiness. The hypotension initially responded to administration of intravenous fluids and dopamine; however, it recurred twice at 18.5 and 24.5 hours after ingestion. These episodes again responded to administration of fluids and dopamine. A plasma captopril level of 27,391.1 nmol/L (5982 ng/mL) was documented, as well as a depressed level of angiotensin converting enzyme. Captopril is an angiotensin converting enzyme inhibitor used in the management of hypertension and ventricular failure; to our knowledge, this is the first case of an acute captopril overdose reported in the English-language literature. The role of captopril in inducing hypotension is discussed herein.
authors.affiliation: Rocky Mountain Poison and Drug Center, Denver, CO 80204.
authors.forename: W L
authors.initials: WL
authors.lastname: Augenstein
authors.forename: K W
authors.initials: KW
authors.lastname: Kulig
authors.forename: B H
authors.initials: BH
authors.lastname: Rumack
mesh_terms: D000328:Adult; D000525:Alprazolam / Q000506:poisoning*; D002216:Captopril / Q000506:poisoning*; D003131:Combined Modality Therapy; D004298:Dopamine / Q000627:therapeutic use; D005260:Female; D005440:Fluid Therapy; D006801:Humans; D007022:Hypotension / Q000139:chemically induced* / Q000628:therapy; D013406:Suicide, Attempted
chemical_list: D002216:Captopril; D004298:Dopamine; D000525:Alprazolam