Severe intoxication after an intentional overdose of amlodipine.
Intoxication with 280 mg of amlodipine caused severe hypotension, third-degree heart block and hyperkalaemia in a 36-year-old female patient. The patient was initially treated with fluids, dopamine, calcium chloride, and epinephrine without effect. The patient was then given a bolus injection of insulin and glucose as a temporary mean to treat the hyperkalaemia. We observed a rise in blood pressure (BP) after insulin was given and the BP was subsequently responsive to epinephrine. A possible positive inotropic effect of insulin therapy in patients with calcium channel blocker intoxication is in accordance with previous findings. In conclusion, it is suggested that hyperinsulinaemia-euglycaemia therapy may be considered as a first-line therapy in calcium channel blocker intoxication.
Rasmussen
L
L
Department of Anaesthesiology Silkeborg County Hospital, Epidemiology and Social Medicine, University of Aarhus, Denmark.
Husted
S E
SE
Johnsen
S P
SP
D000328:Adult; D017311:Amlodipine / Q000506:poisoning*; D002121:Calcium Channel Blockers / Q000506:poisoning*; D062787:Drug Overdose; D005260:Female; D006801:Humans; D007328:Insulin / Q000627:therapeutic use
D002121:Calcium Channel Blockers; D007328:Insulin; D017311:Amlodipine