Amlodipine Overdose: Is High Dose Insulin Ready for Prime Time
Overdose of amlodipine, a dihydropyridine calcium channel blocker (CCB), is distinguished from other CCBs due to longer plasma half-life of 30 to 58 h. As current management strategies of CCB overdose are diverse and institution dependent, this retrospective observational study aimed to compare trea...
| Main Authors: | , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-12-01
|
| Series: | Hearts |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2673-3846/4/1/1 |
| _version_ | 1797858402355904512 |
|---|---|
| author | Mary Jo S. Farmer Anisha Contractor Joshua Allgaier |
| author_facet | Mary Jo S. Farmer Anisha Contractor Joshua Allgaier |
| author_sort | Mary Jo S. Farmer |
| collection | DOAJ |
| description | Overdose of amlodipine, a dihydropyridine calcium channel blocker (CCB), is distinguished from other CCBs due to longer plasma half-life of 30 to 58 h. As current management strategies of CCB overdose are diverse and institution dependent, this retrospective observational study aimed to compare treatment and outcomes data extracted from published case reports of amlodipine overdose with a cohort of patients diagnosed with amlodipine overdose at an urban tertiary medical center. Particular attention was paid to the use of high dose insulin euglycemic therapy (HIET) in treatment of amlodipine overdose. Data was extracted from actual adult patients hospitalized for amlodipine overdose at an urban tertiary medical center up to 2018, and from case reports of amlodipine overdose published between 1997 and 2020. We found a tendency towards earlier and more frequent initiation of HIET over time in management of amlodipine overdose, facilitating hospital discharge. Given the lack of randomized controlled trials comparing vasopressors, HIET, or other therapies, optimal treatment for amlodipine overdose has yet to be definitively established. Based on currently available evidence, a reasonable approach to management of the hemodynamically unstable patient presenting with amlodipine overdose includes vasopressors and inotropes with earlier initiation of HIET. |
| first_indexed | 2024-04-09T21:12:47Z |
| format | Article |
| id | doaj.art-3cbe78a33a364737a1c3dbe5ddfed175 |
| institution | Directory Open Access Journal |
| issn | 2673-3846 |
| language | English |
| last_indexed | 2024-04-09T21:12:47Z |
| publishDate | 2022-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Hearts |
| spelling | doaj.art-3cbe78a33a364737a1c3dbe5ddfed1752023-03-28T13:43:12ZengMDPI AGHearts2673-38462022-12-014111110.3390/hearts4010001Amlodipine Overdose: Is High Dose Insulin Ready for Prime TimeMary Jo S. Farmer0Anisha Contractor1Joshua Allgaier2Department of Medicine, UMASS Chan Medical School-Baystate, Springfield, MA 01199, USADepartment of Medicine, UMASS Chan Medical School-Baystate, Springfield, MA 01199, USADepartment of Medicine, UMASS Chan Medical School-Baystate, Springfield, MA 01199, USAOverdose of amlodipine, a dihydropyridine calcium channel blocker (CCB), is distinguished from other CCBs due to longer plasma half-life of 30 to 58 h. As current management strategies of CCB overdose are diverse and institution dependent, this retrospective observational study aimed to compare treatment and outcomes data extracted from published case reports of amlodipine overdose with a cohort of patients diagnosed with amlodipine overdose at an urban tertiary medical center. Particular attention was paid to the use of high dose insulin euglycemic therapy (HIET) in treatment of amlodipine overdose. Data was extracted from actual adult patients hospitalized for amlodipine overdose at an urban tertiary medical center up to 2018, and from case reports of amlodipine overdose published between 1997 and 2020. We found a tendency towards earlier and more frequent initiation of HIET over time in management of amlodipine overdose, facilitating hospital discharge. Given the lack of randomized controlled trials comparing vasopressors, HIET, or other therapies, optimal treatment for amlodipine overdose has yet to be definitively established. Based on currently available evidence, a reasonable approach to management of the hemodynamically unstable patient presenting with amlodipine overdose includes vasopressors and inotropes with earlier initiation of HIET.https://www.mdpi.com/2673-3846/4/1/1amlodipine overdoseamlodipine poisoningamlodipine toxicityhigh dose insulincalcium channel blocker overdosedihydropyridine |
| spellingShingle | Mary Jo S. Farmer Anisha Contractor Joshua Allgaier Amlodipine Overdose: Is High Dose Insulin Ready for Prime Time Hearts amlodipine overdose amlodipine poisoning amlodipine toxicity high dose insulin calcium channel blocker overdose dihydropyridine |
| title | Amlodipine Overdose: Is High Dose Insulin Ready for Prime Time |
| title_full | Amlodipine Overdose: Is High Dose Insulin Ready for Prime Time |
| title_fullStr | Amlodipine Overdose: Is High Dose Insulin Ready for Prime Time |
| title_full_unstemmed | Amlodipine Overdose: Is High Dose Insulin Ready for Prime Time |
| title_short | Amlodipine Overdose: Is High Dose Insulin Ready for Prime Time |
| title_sort | amlodipine overdose is high dose insulin ready for prime time |
| topic | amlodipine overdose amlodipine poisoning amlodipine toxicity high dose insulin calcium channel blocker overdose dihydropyridine |
| url | https://www.mdpi.com/2673-3846/4/1/1 |
| work_keys_str_mv | AT maryjosfarmer amlodipineoverdoseishighdoseinsulinreadyforprimetime AT anishacontractor amlodipineoverdoseishighdoseinsulinreadyforprimetime AT joshuaallgaier amlodipineoverdoseishighdoseinsulinreadyforprimetime |