Acute amlodipine poisoning in adolescence. Clinical case
Keywords:acute drug poisoning, calcium channel blockers, adolescents
AbstractAcute poisoning in children occupies a leading place among all accidents. Intentional poisoning is more typical for adolescents. Most often, they are drug poisoning caused by the wide choice of drugs and their easy availability. The paper describes a case of acute amlodipine poisoning in an adolescent who took 90 mg of amlodipine simultaneously for suicide. When the patient was admitted to the hospital, her condition was extremely severe due to the symptoms of general intoxication and hemodynamic disorders, in particular, significantly reduced blood pressure. Within the next few days, the patient is most likely to developed non-cardiogenic pulmonary oedema with a significant amount of effusion into the pleural cavity, that required four pleural punctures and additional drug therapy. Gradually, the patient’s condition improved and she was discharged in good condition on the 20th day from the start of treatment after consulting the child by a psychiatrist. Amlodipine, like other dihydropyridines, is a potent vasodilator. Capillary vasodilation that leads to excessive pulmonary capillary extravasation, underlies the non-cardiogenic pulmonary oedema mechanism, that most likely was observed in our patient. Considering the popularity of amlodipine as an effective antihypertensive drug, we can assume that in the future such poisoning may occur in clinical practice of doctors. That is why the physicians should be informed about the clinical symptoms of amlodipine poisoning, the severe complications that may develop in the case of an overdose, and the effective medical measures for such poisoning.
Andriychuk D. Acute drug poisoning in children. Available from: https://www.bsmu.edu.ua/uk/news/digest/5007-gostri-medikamentozni-otruennya-u-ditey. Accessed: 2016 Oct 12. (In Ukrainian).
Bronstein AC, Spyker DA, Cantilena LR Jr, Rumack BH, Dart RC. 2011 Annual report of the American Association of Poison Control Centers' National Poison Data System (NPDS): 29th annual report. Clin Toxicol (Phila). 2012 Dec;50(10):911-1164. doi: 10.3109/15563650.2012.746424.
Naha K, Suryanarayana J, Aziz RA, Shastry BA. Amlodipine poisoning revisited: Acidosis, acute kidney injury and acute respiratory distress syndrome. Indian J Crit Care Med. 2014 Jul;18(7):467-9. doi: 10.4103/0972-5229.136078.
Abduyeva FM, Bychkova OY, Bondarenko IO, et al, authors; Yabluchanskyy MI, Sachenko VM, editors. Clinical pharmacology: a textbook for students and doctors. Kharkiv: Kharkiv national university named by VN Karazin; 2011. 238-246 pp. (in Ukrainian).
Copyright (c) 2019 S.L. Nyankovskyy, R.N. Furtak, M.S. Yatsula, I.Yu. Berezhna, O.M. Mykytchyn, O.I. Romaniv
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our edition uses the copyright terms of Creative Commons for open access journals.
Authors, who are published in this journal, agree with the following terms:
- The authors retain rights for authorship of their article and grant to the edition the right of first publication of the article on a Creative Commons Attribution 4.0 International License, which allows others to freely distribute the published article, with the obligatory reference to the authors of original works and original publication in this journal.
- Directing the article for the publication to the editorial board (publisher), the author agrees with transmitting of rights for the protection and using the article, including parts of the article, which are protected by the copyrights, such as the author’s photo, pictures, charts, tables, etc., including the reproduction in the media and the Internet; for distributing; for the translation of the manuscript in all languages; for export and import of the publications copies of the writers’ article to spread, bringing to the general information.
- The rights mentioned above authors transfer to the edition (publisher) for the unlimited period of validity and on the territory of all countries of the world.
- The authors guarantee that they have exclusive rights for using of the article, which they have sent to the edition (publisher). The edition (the publisher) is not responsible for the violation of given guarantees by the authors to the third parties.
- The authors have the right to conclude separate supplement agreements that relate to non-exclusive distribution of their article in the form in which it had been published in the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.
- The policy of the journal permits and encourages the publication of the article in the Internet (in institutional repository or on a personal website) by the authors, because it contributes to productive scientific discussion and a positive effect on efficiency and dynamics of the citation of the article.
- The rights to the article are deemed transferred by the authors to the edition (the publisher) since the moment of the publication of the article in the printed or electronic version of journal.