Continuous venovenous hemodiafiltration along with charcoal hemoperfusion for the management of life-threatening lercanidipine and amlodipine overdose.
Overdose with calcium channel blockers is uncommon, but is associated with high mortality. The management includes fluid resuscitation, calcium gluconate, glucagon, vasopressors, and high-dose insulin-euglycemia therapy. We describe a rare case of massive overdose of lercanidipine with shock, refractory to conventional therapies and multi-organ failure. Charcoal hemoperfusion with continuous venovenous hemodiafiltration was then used successfully and the patient showed remarkable recovery.
Department of Critical Care Medicine, Max Superspeciality Hospital, New Delhi, India.
Prashant
P
Nasa
Akhilesh
A
Singh
Deven
D
Juneja
Omender
O
Singh
Yash
Y
Javeri
D000368:Aged; D017311:Amlodipine / Q000097:blood / Q000506:poisoning*; D000959:Antihypertensive Agents / Q000097:blood / Q000506:poisoning*; D002121:Calcium Channel Blockers / Q000097:blood / Q000506:poisoning*; D002606:Charcoal / Q000627:therapeutic use*; D004095:Dihydropyridines / Q000097:blood / Q000506:poisoning*; D062787:Drug Overdose / Q000097:blood / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D017583:Hemodiafiltration / Q000379:methods*; D006464:Hemoperfusion / Q000379:methods*; D006801:Humans; D008297:Male; D009102:Multiple Organ Failure / Q000139:chemically induced / Q000628:therapy; D012769:Shock / Q000139:chemically induced / Q000628:therapy; D013997:Time Factors; D016896:Treatment Outcome
D000959:Antihypertensive Agents; D002121:Calcium Channel Blockers; D004095:Dihydropyridines; D002606:Charcoal; D017311:Amlodipine; C060343:lercanidipine