Angiotensin converting enzyme inhibitor intoxication: Naloxone to the rescue? Naloxone for ACE inhibitor intoxication.

We report here the case of a patient with perindopril intoxication inducing severe bradycardia together with a profound hypotension. Initiation of a naloxone infusion completely resolved those symptoms. As a consequence, we could recommend as a first step the use of naloxone in order to prevent the use of more invasive therapeutic tools.

[Intentional poisoning with ACE inhibitors. Emergeny Hospital Iasi]. / Toxicitatea acuta a inhibitorilor enzimei de conversie a angiotensinei. Experienta clinicii de medicina interna si toxicologie, spitalul clinic de urgente "SF Ioan" Iasi.

UNLABELLED: Regarding angiotensin-converting enzyme inhibitors (ACEI) poisoning, only few data are available in the last decade literature. In the previous couple of years especially isolated case reports were published. MATERIAL AND METHOD: We analyzed retrospectively all the patients with acute ACEI poisoning admitted in Iasi Internal Medicine and Toxicology Clinic between 2004 and 2009. RESULTS: 17 cases of poisoning were recorded (enalapril-9 cases, captopril-3 cases, perindopril-3 cases, lisinopril-2 cases). All the poisonings were intentional. A favorable outcome was consistently observed, and were recorded no sequelae or death in this study. The main complain was hypotension, required fluid administration, only one case with 500 mg enalaprilum and severe hypotension required injection of vasopressive amines. No abnormal renal function and no angioedema were noted.