Severe amlodipine toxicity: A medical dilemma managed with therapeutic plasma exchange

IF 1.4 4区医学 Q4 HEMATOLOGY Transfusion and Apheresis Science Pub Date : 2024-06-05 DOI:10.1016/j.transci.2024.103958

Dilna Christy Edison, Joseph Philip, R.S. Mallhi, Ritika Basnotra, Vineeth Pynadath, Kalyani Sane

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Abstract

Amlodipine poisoning is a nightmare for treating clinicians because of the intractable hypotension and bradycardia induced by the drug, which requires a balanced treatment algorithm. We encountered a case of severe Amlodipine toxicity (450 mg) who presented with complaints of nausea, multiple episodes of vomiting, and chest discomfort. On arrival at the EMD, the patient had significant hypotension (80/46 mmHg), bradycardia (40 beats/min), and a fall in oxygen saturation (75 %). He was symptomatically managed with inotropes, IV calcium, IV fluids, and oxygen supplementation. We decided to go forward with Therapeutic Plasma Exchange (TPE) in an attempt to remove the inciting agent. Two sessions of TPE were performed and the patient showed significant improvement post-procedure which led to the discharge of the patient within 10 days of admission. This case report highlights the noteworthiness of TPE in treating significantly high doses of drug poisoning.

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氨氯地平严重中毒：通过治疗性血浆置换解决的医学难题

氨氯地平中毒是临床医生的噩梦，因为该药会诱发难治性低血压和心动过缓，需要采取平衡的治疗算法。我们遇到过一例严重氨氯地平中毒（450 毫克）患者，主诉恶心、多次呕吐和胸部不适。到达急诊科时，患者出现明显低血压（80/46 mmHg）、心动过缓（40 次/分）和血氧饱和度下降（75%）。他接受了肌注、静脉注射钙剂、静脉输液和补氧等对症治疗。我们决定进行治疗性血浆置换术（TPE），试图去除诱发因素。进行了两次治疗性血浆置换后，患者的病情有了明显好转，并在入院后 10 天内出院。本病例报告强调了 TPE 在治疗大剂量药物中毒方面的重要作用。

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来源期刊

Transfusion and Apheresis Science 医学-血液学

CiteScore

3.60

自引率

5.30%

发文量

181

审稿时长

42 days

期刊介绍： Transfusion and Apheresis Science brings comprehensive and up-to-date information to physicians and health care professionals involved in the rapidly changing fields of transfusion medicine, hemostasis and apheresis. The journal presents original articles relating to scientific and clinical studies in the areas of immunohematology, transfusion practice, bleeding and thrombotic disorders and both therapeutic and donor apheresis including hematopoietic stem cells. Topics covered include the collection and processing of blood, compatibility testing and guidelines for the use of blood products, as well as screening for and transmission of blood-borne diseases. All areas of apheresis - therapeutic and collection - are also addressed. We would like to specifically encourage allied health professionals in this area to submit manuscripts that relate to improved patient and donor care, technical aspects and educational issues. Transfusion and Apheresis Science features a "Theme" section which includes, in each issue, a group of papers designed to review a specific topic of current importance in transfusion and hemostasis for the discussion of topical issues specific to apheresis and focuses on the operators'' viewpoint. Another section is "What''s Happening" which provides informal reporting of activities in the field. In addition, brief case reports and Letters to the Editor, as well as reviews of meetings and events of general interest, and a listing of recent patents make the journal a complete source of information for practitioners of transfusion, hemostasis and apheresis science. Immediate dissemination of important information is ensured by the commitment of Transfusion and Apheresis Science to rapid publication of both symposia and submitted papers.