A Survival Case of High-dose Amlodipine Intoxication with Non-cardiogenic Pulmonary Edema: a Case Report

Overview

Journal Ann Med Surg (Lond)

Publisher Wolters Kluwer

Specialty Medical Education

Date 2024 Nov 11

PMID 39525708

Authors

Pankaj Pant

Sangam Shah

Ganesh Bhattarai

Krishna Dahal

Navindra Raj Bista

Sahil Bade

Kshitij Chapagain

Sohail Bade

Sagar Pant

Affiliations

Soon will be listed here.

Abstract

Introduction: Dihydropyridines calcium channel blockers at high dose can have conduction abnormalities, reduced inotropism, and non-cardiogenic pulmonary oedema (NCPE) which otherwise, at standard dosage have only vascular selectivity. They remain one of the commonly used anti-hypertensive exhibiting very lethal outcomes (50% mortality rates) in its overdose.

Case Presentation: The authors present a case of a 21-year-old male with amlodipine intoxication with 43 tabs of 10 mg (total of 430 mg) ingestion manifested by loss of consciousness, hypotension, tachycardia, and respiratory distress.

Discussion: An amlodipine overdose causes refractory hypotension due to vasodilation and impaired cardiac metabolism and contractility. Further amlodipine toxicity can result in NCPE that manifests clinically as respiratory distress and low oxygen levels due to lung injury caused by inflammation and increased vascular permeability.

Conclusion: This case report emphasizes the significance of early recognition and prompt treatment of amlodipine intoxication, which can result in serious complications like fluid overload and respiratory distress.

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