Severe Amlodipine Intoxication Treated by Hyperinsulinemia Euglycemia Therapy

Amlodipine poisoning revisited: Acidosis, acute kidney injury and acute respiratory distress syndrome

“…Gastrointestinal decontamination with activated charcoal constitutes the first line of therapy for patients with CCB overdose;[2] unfortunately this approach is only beneficial when used within the 1 st h of consumption, and could not be employed in our case. Other therapeutic strategies that have been used with varying degrees of success include the hyperinsulinemia-euglycemia technique,[3] continuous IV infusion of calcium,[4] and inotropic support with dopamine, norepinephrine, dobutamine and levosimendan. [5] In this case, it was decided to administer calcium infusion when the patient developed ARDS.…”

Amlodipine poisioning complicated with acute non-cardiogenic pulmonary oedema

“…Only a few cases of serious or fatal overdose have been reported 8. Acute non-cardiogenic pulmonary oedema,9 10 hypodynamic shock11 12 and hyperglycaemia13 are recognised complications of calcium channel blocker overdose.…”

A very rare side effect of amlodipine: non-cardiogenic pulmonary edema

“…Insulin has been reported to increase serum ionized calcium levels and to improve myocardial carbohydrate utilization and has been suggested in treatment. [11] In addition, although methylene blue (Jang et al [12] ) and plasma exchange [13] have been reported to be beneficial in severe intoxication, it was not necessary in our case. Lipid emulsion was reported to be beneficial in lipophilic drugs intoxications, such as calcium channel blockers in two studies.…”