Asunto(s)
Benzazepinas/envenenamiento , Bradicardia/inducido químicamente , Sobredosis de Droga/terapia , Intento de Suicidio , Adulto , Antídotos/farmacología , Antídotos/uso terapéutico , Bradicardia/fisiopatología , Gluconato de Calcio/farmacología , Gluconato de Calcio/uso terapéutico , Terapia Combinada , Sobredosis de Droga/fisiopatología , Electrocardiografía , Femenino , Humanos , Ivabradina , Loperamida/envenenamiento , Losartán/envenenamiento , Norepinefrina/uso terapéutico , Marcapaso Artificial , Intoxicación/tratamiento farmacológico , Intoxicación/terapia , Espironolactona/envenenamientoRESUMEN
In this case report we describe a 62-year-old man, intoxicated with losartan, an angiotensin-II receptor antagonist. The patient presented with a systolic blood pressure of 60 mmHg, metabolic acidosis, and hyperglycaemia. His condition worsened within the first hour of arrival despite infusion of four litres of saline, epinephrine, norepinephrine, and vasopressin as well as insulin and antibiotics. Intravenous methylene blue 75 mg was infused over five minutes. Within 30 minutes his systolic pressure increased to 100 mmHg, and the infusion of epinephrine could be reduced four hours later.
Asunto(s)
Inhibidores Enzimáticos/uso terapéutico , Hipotensión/tratamiento farmacológico , Azul de Metileno/uso terapéutico , Bloqueadores del Receptor Tipo 1 de Angiotensina II/envenenamiento , Inhibidores Enzimáticos/administración & dosificación , Inhibidores Enzimáticos/farmacocinética , Humanos , Hipotensión/inducido químicamente , Losartán/envenenamiento , Masculino , Azul de Metileno/administración & dosificación , Azul de Metileno/farmacocinética , Persona de Mediana EdadRESUMEN
Losartan is a specific angiotensin II receptor antagonist. Although the teratogenic effects of angiotensin converting enzyme (ACE) inhibitors are well documented there are limited reports of losartan induced fetal toxicity. The authors report a case of incomplete ossification of skull bones, transient oliguria and feed intolerance in a newborn following in-utero exposure to losartan.
Asunto(s)
Anomalías Inducidas por Medicamentos , Antihipertensivos/envenenamiento , Muerte Fetal/inducido químicamente , Losartán/envenenamiento , Femenino , Cardiopatías Congénitas/tratamiento farmacológico , Cardiopatías Congénitas/cirugía , Humanos , Embarazo , Complicaciones Cardiovasculares del Embarazo/tratamiento farmacológicoRESUMEN
We report a case of maternal exposure to the antihypertensive drug losartan during weeks 20-31 of pregnancy. We saw the fetal toxic effects of oligohydramnios (decreased amniotic fluid), fetal pulmonary hypoplasia, fetal hypoplastic skull bones, and subsequent fetal death. This pattern of abnormalities is similar to those seen in exposure to angiotensin-converting-enzyme (ACE) inhibitors during pregnancy, and were probably caused by losartan.