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Calcium channel blocker overdose: experience with amlodipine
Supradip Ghosh1, Mrinal Sircar
1Fortis-Escorts Hospital, Neelam Bata Road, Faridabad, Haryana-121 001, India. ghshovan@rediffmail.com
Summary
Two Indian cases of severe amlodipine overdose were successfully managed in the ICU. Treatment involved fluids, vasopressors, calcium, and glucagon, offering critical care insights for calcium channel blocker toxicity.
Area of Science:
- Cardiology
- Clinical Toxicology
- Critical Care Medicine
Background:
- Amlodipine, a widely prescribed calcium channel blocker, presents a risk of overdose, though reports from India are infrequent.
- Understanding the management of severe amlodipine overdose is crucial for critical care physicians.
Observation:
- Two patients presented with near-fatal amlodipine overdose requiring intensive care unit (ICU) admission.
- The clinical course necessitated aggressive supportive management.
Findings:
- Successful management was achieved using a combination of fluid resuscitation, vasopressors, intravenous calcium infusion, and glucagon.
- This multi-modal approach effectively addressed the cardiovascular complications of the overdose.
Implications:
- The reported cases highlight effective treatment strategies for severe amlodipine overdose in the Indian context.
- Glucagon emerges as a potentially valuable therapeutic option in managing refractory hypotension due to calcium channel blocker toxicity.
- These findings contribute to the limited literature on amlodipine overdose management, particularly in resource-limited settings.
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