Patients with poisoning from antihypertensive drugs are dialysis and emergency at Le Van Thinh Hospital. Photo: BVCC
The first case is a 30-year-old male patient with a history of infrequent treatment of hypertension, admitted to the hospital in a state of dizziness, lightheadedness, and easy falls. The patient’s family said that the patient was sad regarding work recently, and sometimes confided that he was depressed and did not want to live.
At noon on the same day of admission, the patient was discovered by his brother lying motionless on the floor, still conscious, but dizzy, unable to sit still. The patient claimed to have taken all 30 tablets of amlodipine 5mg, an antihypertensive drug (total dose of 150mg) for more than 4 hours.
The patient was taken to the emergency room in a state of sluggishness, slow exposure, pulse 100 beats/min, blood pressure 70/40 mmHg, severe metabolic acidosis, suspected due to hypotension due to drug overdose.
The patient was immediately placed on a nasogastric tube, gastric lavage with activated charcoal, combined with intensive resuscitation therapy with vasopressors. After 30 minutes of resuscitation, the patient’s vital signs gradually stabilized, however, at this time, acute kidney damage with metabolic acidosis occurred.
Immediately, the patient underwent adsorbent dialysis combined with slow continuous extracorporeal hemodialysis to rapidly remove amlodipine. After 72 hours of intensive care, the patient was finally successfully resuscitated, his consciousness was alert, his vital signs were stable, he was transferred to a psychological examination before being discharged home with his family.
The second case is a female patient, born in 1967, hospitalized with severe hypotension and dizziness. The patient is a person with a history of hypertension, dyslipidemia, depression, and is prescribed by a doctor to take antihypertensive drugs regularly.
According to the daughter, on the same day of admission, the patient took 28 tablets of amlodipine 5mg combined with perindopril 5mg which are powerful antihypertensive drugs and 28 tablets of sulpiride 50mg (antipsychotics).
After 80 hours of emergency and intensive resuscitation with the use of vasopressors, fluid resuscitation, high-concentration insulin infusion, sugar infusion, adsorbent dialysis combined with continuous extracorporeal dialysis, the patient passed away. critical crisis.
Doctor Vo Tan Duoc, Department of Cardiology – Gerontology, Le Van Thinh Hospital, said that amlodipine is a very popular antihypertensive drug, usually prescribed with a dose of 1-2 tablets/day. However, the High doses of amlodipine can lead to toxicity. Initial symptoms may be non-specific such as dizziness, fatigue, lightheadedness, in severe cases may decline rapidly leading to altered mental status, coma, shock leading to death.
