Extracorporeal therapy for amlodipine poisoning

Ramanathan, Kollengode; Mohanty, Bishwabikash; Tang, Simeon; MacLaren, Graeme

doi:10.1007/s10047-019-01132-4

Cited by 11 publications

(14 citation statements)

References 12 publications

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“…LVEF was frequently measured and found <40% despite inotropes in most patients except two CCBpoisoned patients 14,20 and one BB/CCB-poisoned patient. 15 Whether ECLS is useful in preserved LVEF patients is unclear.…”

Section: Discussionmentioning

confidence: 99%

“…12 ECLS is considered by experts as the rescue option to treat CCB-poisoned patients if cardiac function is depressed and shock not controlled by calcium salts, high-dose insulin, vasopressors/inotropes and lipid emulsion. 13 In case reports describing CCB-poisoned patients treated with ECLS (Table 1), indications were severe shock 12,[14][15][16][17][18][19][20] and refractory cardiac arrest. 21 ECLS 1).…”

Section: Ecls To Treat Ccb-poisoned Patientsmentioning

confidence: 99%

“…In two patients, LVEF was found normal (65%) on 0.2 μg/kg/min epinephrine, 0.21 μg/kg/min norepinephrine and 0.04UI/min vasopressin. 14 LVEF was 70% in another patient on 30 μg/kg/min dopamine, 60 μg/min norepinephrine and 1 μg/min epinephrine and phenylephrine (dose not provided). 20 Interestingly, in this patient, echocardiography performed on day 2 of ECLS showed severely decreased LVEF of 10%, 20 proving that severe cardiac dysfunction occurred and suggesting that close monitoring should be performed in patients with severe shock and preserved LVEF as severe cardiac dysfunction can develop later.…”

Section: Ecls To Treat Ccb-poisoned Patientsmentioning

confidence: 99%

“…ECLS is considered by experts as the rescue option to treat CCB‐poisoned patients if cardiac function is depressed and shock not controlled by calcium salts, high‐dose insulin, vasopressors/inotropes and lipid emulsion 13 . In case reports describing CCB‐poisoned patients treated with ECLS (Table 1 ), indications were severe shock 12,14–20 and refractory cardiac arrest 21 . ECLS was initiated, while patients were treated with two to four various inotropes/vasopressors, administered at high doses including 0.2–2.6 μg/kg/min epinephrine, 0.21–60 μg/kg/min norepinephrine, 3–30 μg/kg/min dopamine and 0.04 IU/min vasopressin.…”

Section: Ecls To Treat Ccb‐poisoned Patientsmentioning

confidence: 99%

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Extracorporeal life support in cardiotoxicant poisoning—A narrative review

Voicu

M’Rad

Malissin

et al. 2022

Basic Clin Pharma Tox

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Extracorporeal life support (ECLS) improves circulation in life‐threatening cardiac dysfunction or arrest patients. Its benefits in drug‐induced cardiovascular complications are debated. Indications and outcomes are poorly established. We performed a narrative review discussing ECLS indications, timing and results in cardiotoxicant‐poisoned patients. The review was focused on antiarrhythmic drugs and aluminium phosphide. Literature analysis was limited to the past 30 years in adults. Most reports were single cases and retrospective except one prospective case series of limited size, two of them controlled. ECLS indications and timing were at the discretion of physicians in charge but mostly included persistent cardiovascular failure despite elevated doses of inotropic/vasopressor support associated with elevated blood lactate concentrations (usually, >5 mmol/L) and collapsed left ventricular ejection fraction (LVEF; usually, ≤40%). Survival improved using ECLS versus standard care in one study. Survival was ~80% if ECLS was implemented in refractory cardiovascular failure and 25%–66% if implemented in cardiac arrest. In two controlled studies, survival of ECLS‐treated aluminium phosphide‐poisoned patients was improved versus standard care, if implemented in the presence of systolic blood pressure ≤80 mmHg despite inotropic/vasopressor treatment, arterial pH ≤ 7.0 and LVEF ≤ 40%. Despite low‐to‐moderate level of evidence, ECLS seems effective to improve survival in selected cardiotoxicant‐poisoned patients. Selection criteria need clarification.

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Section: Discussionmentioning

confidence: 99%

Section: Ecls To Treat Ccb-poisoned Patientsmentioning

confidence: 99%

Section: Ecls To Treat Ccb-poisoned Patientsmentioning

confidence: 99%

Section: Ecls To Treat Ccb‐poisoned Patientsmentioning

confidence: 99%

See 2 more Smart Citations

Extracorporeal life support in cardiotoxicant poisoning—A narrative review

Voicu

M’Rad

Malissin

et al. 2022

Basic Clin Pharma Tox

View full text Add to dashboard Cite

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“…The half-life of amlodipine is 30-50 hr and had a larger volume of distribution (21 L/Kg). 5 Due to its beneficial features, such as once-daily dosing and minimal effects on heart rate, amlodipine is commonly used in clinical practice. 4 When CCBs are administered in more than the prescribed dosage, and they result in symptoms including bradycardia and hypotension.…”

Section: Discussionmentioning

confidence: 99%

Case Report-Amlodipine Toxicity

Surendran¹,

Karthika²,

MK³

et al. 2022

IJOPP

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Amlodipine is a dihydropyridine calcium channel blocker mainly indicated in the treatment of essential hypertension and angina pectoris. Overdose of calcium channel blocker, Amlodipine results in toxicity along with profound hypotension and shock. Here, a 20-year-old female patient was admitted to the MICU with complaints of severe breathing difficulty, and multiple episodes of vomiting one day earlier. After the chest x-ray, ECG, and blood investigations, she was diagnosed as having Amlodipine toxicity, pulmonary edema, circulatory shock, hypocalcemia, hypokalemia, systemic hypotension, and acute kidney injury. She was discharged from the hospital after the symptoms had recovered.

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Multiple drugs

2019

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Extracorporeal therapy for amlodipine poisoning

Cited by 11 publications

References 12 publications

Extracorporeal life support in cardiotoxicant poisoning—A narrative review

Extracorporeal life support in cardiotoxicant poisoning—A narrative review

Case Report-Amlodipine Toxicity

Multiple drugs

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