PDF(Pubmed)
Abstract：
BACKGROUND Amlodipine, a calcium channel blocker, and atenolol, a beta blocker, are commonly used as a fixed drug combination (FDC) to treat hypertension. Intentional or non-intentional overdose of amlodipine-atenolol results in hypotension and myocardial depression with a high risk of mortality. This report describes a 64-year-old man with an overdose of amlodipine-atenolol, presenting as an emergency with hypotension, bradycardia, and severe metabolic acidosis. He was successfully treated with intravenous calcium chloride infusion, hyperinsulinemia euglycemia therapy (HIE), and continuous veno-venous hemodialysis (CVVHD). CASE REPORT A 64-year-old man was diagnosed with essential hypertension 1 week prior to the admission. He had been prescribed 1 FDC tablet of amlodipine and atenolol (5+50 mg) per day; however, he took 1 table of the FDC per day for 3 days and then took 3-4 tablets each day during the next 4 days. He was brought to the hospital with hypotension, bradycardia, and severe metabolic acidosis and was diagnosed with amlodipine-atenolol overdose. He was treated with intravenous calcium chloride infusion, HIE, and CVVHD. His hemodynamics started to improve after administering these therapies for 6 h. Inotropes were gradually tapered off and stopped. He was extubated on day 5 and recovered completely. CONCLUSIONS This report shows the serious effects amlodipine-atenolol overdose and the challenges of emergency patient management. An overdose of FDC of amlodipine and atenolol can cause cardiovascular collapse and severe metabolic acidosis. Timely and aggressive management with intravenous calcium infusion, HIE, and CVVHD is essential.
摘要：
背景氨氯地平,钙通道阻滞剂,和阿替洛尔,β受体阻滞剂,通常用作固定药物组合(FDC)来治疗高血压。氨氯地平-阿替洛尔的有意或无意过量会导致低血压和心肌抑制，并有很高的死亡风险。这份报告描述了一名64岁的男子服用氨氯地平-阿替洛尔过量，表现为低血压的紧急情况，心动过缓,和严重的代谢性酸中毒.静脉输注氯化钙成功治疗,高胰岛素血症正常血糖疗法（HIE），和持续静脉-静脉血液透析（CVVHD）。病例报告一名64岁男性在入院前1周被诊断为原发性高血压。他每天服用1片氨氯地平和阿替洛尔（5+50mg）的FDC；然而，他每天服用1片FDC，持续3天，然后在接下来的4天内每天服用3-4片。他因低血压被送到医院,心动过缓,和严重的代谢性酸中毒，并被诊断为氨氯地平-阿替洛尔过量。他接受了静脉注射氯化钙治疗，HIE,CVVHD在施用这些疗法6小时后，他的血液动力学开始改善。内在剂逐渐减少并停止。他在第5天拔管并完全恢复。结论本报告显示了氨氯地平-阿替洛尔过量的严重影响和急诊患者管理的挑战。氨氯地平和阿替洛尔的FDC过量可引起心血管崩溃和严重的代谢性酸中毒。及时积极的静脉补钙管理，HIE,CVVHD是必不可少的。
