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Nifedipine poisoning in a child
T G Wells1, C J Graham, M M Moss
1Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock.
Pediatrics
|July 1, 1990
Summary
A massive nifedipine overdose in an infant caused cardiac arrest, seizures, and blindness. Prompt medical intervention and resuscitation led to a full recovery without lasting effects.
Area of Science:
- Cardiology
- Pediatric Toxicology
- Neurology
Background:
- Nifedipine is a calcium channel blocker used to treat hypertension and angina.
- Infant overdose of nifedipine is rare but can be life-threatening.
Observation:
- A 14-month-old child ingested a large dose of nifedipine, presenting with unresponsiveness, severe hypotension, and hyperglycemia.
- Electrocardiogram revealed third-degree atrioventricular block progressing to cardiac arrest.
Findings:
- Cardiopulmonary resuscitation, mechanical ventilation, and intravenous fluids (normal saline, calcium chloride, dopamine) were necessary for resuscitation.
- Complications included pulmonary edema, cerebral infarction leading to cortical blindness, and seizures with abnormal electroencephalogram.
- The child recovered fully without apparent long-term sequelae.
Implications:
- Massive nifedipine overdose in infants is a critical medical emergency requiring immediate and aggressive management.
- This case highlights the severe cardiotoxic and neurotoxic effects of nifedipine in young children.
- Prompt recognition and intervention are crucial for favorable outcomes in pediatric nifedipine intoxication.