title: Prolonged profound hypotension complicating severe methyldopa overdose.
abstract: OBJECTIVE
  Methyldopa, a centrally acting antihypertensive drug, has been in use since the 1960s, but reports of (severe) overdose are rare. We present a case of severe methyldopa overdose with prolonged profound hypotension.
  
  
  METHODS
  A 50-year-old woman developed sinus bradycardia, prolonged profound hypotension, and drowsiness after ingesting over 300 tablets (> 75 g) of methyldopa. At presentation, her blood pressure was 59/27 mmHg, heart rate 49 beats/minute, and Glasgow Coma Scale Score 14. She needed intensive care unit (ICU) care and intravenous infusion of a large amount of fluids and GelofusineÂ®, injections of ephedrine sulphate, and intravenous infusion of norepinephrine for 41 hours followed by dopamine for 21 hours to maintain her systolic blood pressure at ~ 100 mmHg. She was observed for 3 more days in the general ward before discharge.
  
  
  CONCLUSIONS
  Severe methyldopa overdose can be complicated by prolonged profound hypotension. The management of these patients should include close monitoring of vital functions and administration of intravenous fluids, colloids, and vasopressor agents.
authors.forename: Thomas Y K
authors.initials: TY
authors.lastname: Chan
authors.forename: Gavin M
authors.initials: GM
authors.lastname: Joynt
mesh_terms: D000959:Antihypertensive Agents / Q000506:poisoning*; D062787:Drug Overdose; D005260:Female; D006801:Humans; D007022:Hypotension / Q000139:chemically induced*; D008750:Methyldopa / Q000506:poisoning*; D008875:Middle Aged
chemical_list: D000959:Antihypertensive Agents; D008750:Methyldopa