Tejasvi C Consultant, Department of Anaesthesiology, Cloud Nine Hospital, Bengaluru 560048, Karnataka, India
C. Preethi Goutham Registrar, Department of Critical Care Medicine, Fortis Hospital, Bengaluru 560076, Karnataka, India
Address for correspondence: C. Preethi Goutham, Registrar, Department of Critical Care Medicine, Fortis Hospital, Bengaluru 560076, Karnataka, India E-mail: preethigoutham89@gmail.com
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Tejasvi C, Goutham CP. The role of plasmapheresis in amlodipine overdose. Ind J Anesth Analg. 2024;11(3):139-41.
Timeline
Received : March 20, 2024
Accepted : May 28, 2024
Published : September 28, 2024
Abstract
Amlodipine overdose is scarcely reported from India, though rare but associated with high mortality. It can lead profound refractory hypotension and shock leading to end organ damage. Management involves early and aggressive measures and calcium in large doses to overcome competitive blockade, hyperinsulinemiaeugycemic therapy, along with some rescue therapies tried in anectodal reports. We report one such case of amlodipine overdose and was successfully managed.
References
1. DeWitt CR, Walksman JC. Pharmacology, pathophysiology and management of calcium channel blocker and B-blocker toxicity. Toxicol Rev 2004;23:223-38.
2. Tapan Patel, MD, David Tietze, MD, Amlodipine overdose.Proc (BaylUniv Med Cent). 2013 Oct; 26(4): 410–411.
3. Kenny J. Treating overdose with calcium channel blockers. BMJ. 1994;308:992–3. [PMC free article] [PubMed] [Google Scholar].
4. Saravu K, Balasubramanian R. Near-Fatal Amlodipine poisoning. J Assoc Physicians India. 2004;52:156–7. [PubMed] [Google Scholar].
5. Russel RP. Side effects of calcium channel blockers. Hypertension. 1988;13:I37–40. [Google Scholar].
6. Yuan TH, Kerns WP, II, Tomaszewski CA, Ford MD, Klinc JA. Insulin glucose as adjunctive therapy for severe calcium channel antagonist poisoning. ClinToxicol. 1999;37:463–74. [PubMed] [Google Scholar].
7. Boyer EW, Shannon M. Treatment of calcium channel blocker intoxication with insulin infusion. N Engl J Med. 2001;344:1721–2. [PubMed] [Google Scholar].
8. Kute VB, Shah PR, Goplani KR, Gumber MR, Vanikar AV, Trivedi HL. Successful treatment of refractory hypotension, noncardiogenic pulmonary edema and acute kidney injury after an overdose of amlodipine. Indian J Crit Care Med. 2011;15:182–4 [PMC free article] [PubMed] [Google Scholar].
9. Lheureux PE, Zahir S, Gris M, Derrey AS, Penaloza A. Bench-to-bedside review: hyperinsulinaemia/euglycaemia therapy in the management of overdose of calcium-channel blockers. Crit Care. 2006;10(3):212. [PMC free article] [PubMed] [Google Scholar].
10. Azendour H, Belyamani L, Atmani M, Balkhi H, Haimeur C. Severe amlodipine intoxication treated by hyperinsulinemia euglycemia therapy. J Emerg Med. 2010;38(1):33–35. [PubMed] [Google Scholar].
11. Schwartz J, Padmanabhan A, Aqui N et al. Guidelines on the use of therapeutic apheresis in clinical practice-evidence-based approach from the writing committee of the American Society for Apheresis: the seventh special issue. J ClinApher. 2016;31:149-162.
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Tejasvi C, Goutham CP. The role of plasmapheresis in amlodipine overdose. Ind J Anesth Analg. 2024;11(3):139-41.
This license enables reusers to distribute, remix, adapt,
and build upon the material in any medium or format for noncommercial purposes
only, and only so long as attribution is given to the creator.
This license enables reusers to distribute, remix, adapt,
and build upon the material in any medium or format for noncommercial purposes
only, and only so long as attribution is given to the creator.