[Deep hypotension with transient oliguria and severe heart failure in course of acute intentional poisoning with amlodipine].
A case of acute poisoning with amlodipine with deep hypotension, transient oliguria and clinical signs of acute heart failure was described. A woman of 23 years swallowed intentionally 60 tablets of amlodipine (600 mg). After eleven hours of ingestion she was admitted to Warsaw Poison Control Centre. She was in severe clinical condition; tachycardia and deep hypotension were the prominent signs of poisoning. There was not CNS depression. Intensive treatment with i.v. catecholamines (dopamine, norepinephrine), crystalloids (with continuous control of central venous pressure), and i.v. calcium salts (with control of plasma calcium concentration) was started immediately. The patient did not improve but got worse. Acute heart failure developed, especially of left ventricle, so i.v. crystalloids were stopped and dubutamin, morphine, nitroglycerin and glucagon were introduced. Because of oliguria and insufficient effect of high doses of furosemide four-hours hemodiafiltration was set in. The patient's condition slowly improve after third and forth day of hospitalization. The systolic blood pressure rose, heart work was really better and on sixth day--the stabilization of diastolic blood pressure was definitely achieved. The patient was discharge in good condition with heart ejection fraction of 65% measured echocardiographically.
Feldman
R
R
III Oddział Chorób Wewnetrznych, Stołeczny Ośrodek Ostrych Zatruć.
Glińska-Serwin
M
M
D000328:Adult; D017311:Amlodipine / Q000506:poisoning*; D000959:Antihypertensive Agents / Q000506:poisoning*; D002121:Calcium Channel Blockers / Q000506:poisoning*; D062787:Drug Overdose / Q000175:diagnosis / Q000628:therapy; D005260:Female; D006333:Heart Failure / Q000139:chemically induced* / Q000188:drug therapy; D006801:Humans; D007022:Hypotension / Q000139:chemically induced* / Q000188:drug therapy; D009846:Oliguria / Q000139:chemically induced* / Q000188:drug therapy; D013406:Suicide, Attempted; D016896:Treatment Outcome
D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D017311:Amlodipine