scholarly journals Angiotensin-II receptor antagonist combined with calcium channel blocker or diuretic for essential hypertension

2009 ◽  
Vol 32 (11) ◽  
pp. 962-968 ◽  
Author(s):  
Toshihiko Ishimitsu ◽  
Atsushi Numabe ◽  
Toshihide Masuda ◽  
Tomoyuki Akabane ◽  
Atsushi Okamura ◽  
...  
Keyword(s):  
Essential Hypertension ◽  
Angiotensin Ii ◽  
Calcium Channel ◽  
Receptor Antagonist ◽  
Calcium Channel Blocker ◽  
Channel Blocker ◽  
Angiotensin Ii Receptor ◽  
Angiotensin Ii Receptor Antagonist

scholarly journals Prolonged Refractory Hypotension following Combined Amlodipine and Losartan Ingestion Responsive to Metaraminol

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
James O. M. Plumb ◽  
Craig Stewart ◽  
Michael Eddleston ◽  
Thearina de Beer
Keyword(s):  
Angiotensin Ii ◽  
Calcium Channel ◽  
Receptor Antagonist ◽  
Calcium Channel Blocker ◽  
Channel Blocker ◽  
High Dose ◽  
Angiotensin Ii Receptor ◽  
Angiotensin Ii Receptor Antagonist ◽  
Severe Hypotension ◽  
Refractory Hypotension

Introduction. Overdose with the calcium channel blocker amlodipine can cause profound hypotension that may be exacerbated by the concurrent ingestion of an angiotensin II receptor antagonist. Best management of such overdoses is uncertain although the use of hyperinsulinaemia-euglycaemia (HIE) has been recommended.Case report. We report a case of mixed amlodipine and losartan overdose in a 50-year-old lady. Severe hypotension was resistant to conventional vasopressors and high-dose insulin/euglycaemia, but did respond to a metaraminol infusion.Conclusion. A trial of metaraminol early in severe cases of calcium channel blocker and angiotensin II receptor antagonist toxicity may be of benefit, especially when conventional ionotropic treatment measures are failing.

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