Work

Refractory Hypotension and Delayed Respiratory Failure in Amlodipine Toxicity: A Multimodal Management Approach

Year: 2025

Type: article

Abstract: Pulmonary oedema is a rare but possible paradoxical complication following the withdrawal of high-dose insulin euglycemic therapy (HIET). In the context of calcium channel blocker (CCB) toxicity, other potential confounding factors that could account for delayed pulmonary oedema include inadvertent fluid overload from management of hypotension caused by CCB toxicity, delayed toxicodynamic effects on the pulmonary vasculature and the heart, or a previously unknown underlying cardiac dysfunction. We report a case involving a woman in her early 50s who developed a symptomatic pulmonary oedema following the discontinuation of HIET used in the management of refractory hypotension complicating a massive amlodipine intoxication. This unexpected deterioration occurred despite improved haemodynamics following HIET used in the management of amlodipine toxicity. We have reviewed this case in relation to the existing literature on delayed or paradoxical pulmonary oedema complicating CCB toxicity, to the benefit of clinical personnel managing future similar cases.

Source: Cureus

DOI: 10.7759/cureus.98430

Authors: Maria Haq, Chima Iloanugo, Rabiu Momoh

Institutions: Medway Maritime Hospital, Maidstone and Tunbridge Wells NHS Trust

Language: English

Topic: Poisoning and overdose treatments

Subfield: Emergency Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: diamond

OpenAlex ID: W4416982024