Conventional and Unconventional Lifesaving Therapies in an Adolescent With Amlodipine Ingestion

2016 ◽  
Vol 36 (4) ◽  
pp. 64-69 ◽  
Author(s):  
Karin E. Reuter-Rice ◽  
Bradley M. Peterson
Keyword(s):  
Critical Care ◽  
Calcium Channel ◽  
Calcium Channel Blocker ◽  
Channel Blocker ◽  
Short Term ◽  
Care Nurse ◽  
Severe Hypotension ◽  
Treatment Of Hypertension ◽  
Dihydropyridine Calcium Channel Blocker ◽  
Life Threatening

Amlodipine, a dihydropyridine calcium channel blocker, is commonly prescribed for the treatment of hypertension. Ingestion of an overdose leads to severe hypotension; if the hypotension is not treated, death may be imminent. Conventional and unconventional interventions were used to treat an adolescent who ingested a life-threatening dose of amlodipine. Severe hypotension resistant to conventional treatment with intralipids and hyperinsulinemia-euglycemia therapy led to the use of plasmapheresis and a pneumatic antishock garment as lifesaving measures. Plasmapheresis has been described in only one other case of severe amlodipine overdose, and the use of a pneumatic antishock garment has never been described in the management of a calcium channel blocker overdose. Because short-term use of a pneumatic antishock garment has associated risks, the critical care nurse’s anticipation of side effects and promotion of safe use of the garment were instrumental in the patient’s care and outcome. (Critical Care Nurse. 2016; 36[4]:64–69)

scholarly journals Effect of Dihydropyridine Calcium-Channel Blocker on Adverse Aortic Events After Thoracic Endovascular Aortic Repair for Type B Aortic Dissection

2021 ◽  
Author(s):  
Fan Yang ◽  
Lyufan Chen ◽  
Jitao Liu ◽  
Songyuan Luo ◽  
Caiyun He ◽  
...  
Keyword(s):  
Propensity Score ◽  
Aortic Dissection ◽  
Calcium Channel ◽  
Propensity Score Matching ◽  
Calcium Channel Blocker ◽  
Channel Blocker ◽  
Thoracic Endovascular Aortic Repair ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Dihydropyridine Calcium Channel Blocker

Abstract Objectives: This study aimed to evaluate the effect of dihydropyridine calcium-channel blocker (CCB) on adverse aortic events (AAE) in patients undergoing thoracic endovascular aortic repair (TEVAR) for type B aortic dissection (TBAD). Methods: A retrospective study was conducted on patients undergoing TEVAR of TBAD from January 2010 to December 2017 in our center. Patients were divided into CCB group and non-CCB group according to the postoperative dihydropyridine CCB use. AAE including aorta-relative mortality and reintervention, were compared between these two groups. Propensity score matching analysis was performed to avoid the potential effect of known confounders.Results: Before matching, the study cohort comprised 548 patients, including 435 (79.4%) and 113 (20.6%) patients in the CCB and non-CCB groups, respectively. After matching, 101 patients in each group were eligible for the analysis. In the unmatched cohort, AAE occurred in 52 (12.0%) and 29 (25.7%) patients in the CCB and non-CCB groups, respectively (P < 0.001). In the matched cohort, AAE occurred in 8 (7.9%) and 22 (21.8%) patients in the CCB and non-CCB groups, respectively (P = 0.013). Log-rank test analysis revealed that the levels of freedom from AAE were significantly different between the 2 groups in both the unmatched and matched cohorts (P < 0.001 and P = 0.007, respectively). Multivariable analysis showed that CCB use (hazard ratio 0.50, 95% confidence interval 0.32–0.80; P = 0.003) was associated with a lower AAE rate after adjustment for other variables, and was minimally changed after the propensity score matching (HR 0.34, 95% CI 0.15–0.75; P = 0.008).Conclusions: Postoperative dihydropyridine CCB use is protective in patients undergoing TEVAR for acute and sub-acute TBAD.

Sign in / Sign up

Export Citation Format

Share Document