Clinical Course in Patients with an Intentional Amlodipine Overdose / 대한내과학회지
Korean Journal of Medicine
; : 208-214, 2011.
Article
em Ko
| WPRIM
| ID: wpr-109364
Biblioteca responsável:
WPRO
ABSTRACT
BACKGROUND/AIMS:
Calcium channel blockers (CCBs) are anti-hypertensive medications that are used worldwide. CCB overdose has increased in proportion to the use of these drugs. Although amlodipine is the most widely used CCB, many physicians are not familiar with amlodipine overdose. We report the clinical outcome in patients with an intentional amlodipine overdose.METHODS:
We retrospectively reviewed the medical records of the patients who visited Soonchunhyang University Cheonan Hospital with an amlodipine overdose from January 2002 through December 2010. We recorded the initial vital signs, blood chemistry, electrocardiography, and estimated amount of amlodipine ingested.RESULTS:
Nine patients were enrolled, of whom two patients died. Both patients who died had ingested more than 200 mg/m2 of amlodipine, while all of the patients who ingested less than 200 mg/m2 of amlodipine survived. Three patients had blood sugar levels exceeding 200 mg/dL and two of these died despite high-dose insulin therapy in combination with glucose infusion (hyperinsulinemia/euglycemia therapy). Although three patients also took a glimepiride overdose, none had hypoglycemia. The amount of amlodipine ingested relative to the body surfaced area (BSA) was 197.1 +/- 92.3 mg/m2 in patients with an abnormal ECG and 58.5 +/- 27.1 mg/m2 in patients with a normal ECG.CONCLUSIONS:
Amlodipine overdose can induce hyperglycemia, resulting in lethal cardiogenic shock owing to the decreased calcium influx, inappropriate energy production, and weakened inotropic effect. Therefore, amlodipine-induced hyperglycemia indicates a poor prognosis.Palavras-chave
Texto completo:
1
Base de dados:
WPRIM
Assunto principal:
Prognóstico
/
Choque Cardiogênico
/
Compostos de Sulfonilureia
/
Glicemia
/
Bloqueadores dos Canais de Cálcio
/
Prontuários Médicos
/
Cálcio
/
Estudos Retrospectivos
/
Anlodipino
/
Eletrocardiografia
Tipo de estudo:
Observational_studies
/
Prognostic_studies
Limite:
Humans
Idioma:
Ko
Revista:
Korean Journal of Medicine
Ano de publicação:
2011
Tipo de documento:
Article
País de publicação:
COREA DEL SUR
/
COREIA DO SUL
/
KR
/
SOUTH KOREA