Amlodipine intoxication complicated by acute kidney injury and rhabdomyolysis.
10.12701/yujm.2015.32.1.17
- Author:
In Hee LEE
1
;
Gun Woo KANG
Author Information
1. Department of Internal Medicine, Catholic University of Daegu School of Medicine, Daegu, Korea. ihlee@cu.ac.kr
- Publication Type:Case Report
- Keywords:
Amlodipine;
Calcium channel blocker;
Intoxication;
Rhabdomyolysis;
Acute kidney injury
- MeSH:
Acute Kidney Injury*;
Aged;
Alkalies;
Amlodipine*;
Arrhythmias, Cardiac;
Calcium Channels;
Calcium Gluconate;
Creatine Kinase;
Creatinine;
Eating;
Female;
Glucagon;
Glucose;
Heart Arrest;
Hemodiafiltration;
Hemodynamics;
Humans;
Hypertension;
Hypotension;
Insulin;
Myocardial Infarction;
Myoglobin;
Pulmonary Edema;
Respiration, Artificial;
Rhabdomyolysis*;
Shock;
Suicide, Attempted;
Tablets;
Water
- From:Yeungnam University Journal of Medicine
2015;32(1):17-21
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Amlodipine, a calcium channel blocker of the dihydropyridine group, is commonly used in management of hypertension, angina, and myocardial infarction. Amlodipine overdose, characterized by severe hypotension, arrythmias, and pulmonary edema, has seldom been reported in Korean literature. We report on a fatal case of amlodipine intoxication with complications including rhabdomyolysis and oliguric acute kidney injury. A 70-year-old woman with a medical history of hypertension was presented at the author's hospital 6 hours after ingestion of 50 amlodipine (norvasc) tablets (total dosage 250 mg) in an attempted suicide. Her laboratory tests showed a serum creatinine level of 2.5 mg/dL, with elevated serum creatine phosphokinase and myoglobin. The patient was initially treated with fluids, alkali, calcium gluconate, glucagon, and vasopressors without a hemodynamic effect. High-dose insulin therapy was also started with a bolus injection of regular insulin (RI), followed by continuous infusion of RI and 50% dextrose with water. Despite intensive treatment including insulin therapy, inotropics, mechanical ventilation, and continuous venovenous hemodiafiltration, the patient died of refractory shock and cardiac arrest with no signs of renal recovery 116 hours after her hospital admission.
