Successful Treatment of an Adolescent with Severe Amlodipine Poisoning with Charcoal Hemoperfusion

Introduction

The United States Poison Control Center’s National Poison Data System reports toxic exposures in approximately 2 million people annually, 56% of whom are pediatric. Cardiovascular drugs rank sixth among drug exposures in children, with calcium channel blockers (CCB) being the sixth-ranked drugs associated with 5.2% of drug exposure-related deaths. Therefore, early diagnosis and treatment of CCB poisoning are crucial (Gummin D et al., Clin Toxicol 2023; 61: 717–939, Benson BE et al., J Emerg Med 2010; 39: 186–193).

This case report reviews the management of CCB toxicity in pediatric patients, focusing on charcoal hemoperfusion (HP) therapy. We administered to a patient who ingested amlodipine with suicidal intent. Despite conventional treatments like intravenous calcium, glucagon, hyperinsulinemic euglycemia (HIE), intravenous lipid emulsion (ILE) therapy, and high doses of inotropic agents, the patient had persistent hypotension, necessitating the use of charcoal HP therapy.

Publication History

Article published online:
07 February 2025