Affiliation:
1. From the Department of Pediatrics, University of Arkansas for Medical Sciences, Little Rock, and the Divisions of Pediatric Clinical Pharmacology, Pediatric Nephrology, Critical Care Medicine, and Pediatric Cardiology, Arkansas Children's Hospital, Little Rock, Arkansas
Abstract
A 14-month-old child ingested approximately 800 mg (70 mg/kg) of nifedipine. When first examined, the child was unresponsive, markedly hypotensive, and hyperglycemic. According to electrocardiographic results, there was a third-degree atrioventricular block that rapidly progressed to cardiac arrest. Following successful cardiopulmonary resuscitation, mechanical ventilation and resuscitation with intravenous normal saline, calcium chloride and dopamine were required to restore perfusion, reverse metabolic acidosis, and stabilize vital signs. Complications related to nifedipine intoxication included the development of pulmonary edema and possible infarction in the posterior parietal and occipital lobes associated with cortical blindness and the development of seizures with an abnormal electroencephalogram. The patient recovered without clinically apparent residua. Massive nifedipine overdose in infants represents a potentially life-threatening event that requires prompt medical attention. Reported cases of nifedipine intoxication were reviewed and therapeutic interventions Received for publication Jan 23, 1989; accepted Aug 16, 1989. were discussed.
Publisher
American Academy of Pediatrics (AAP)
Subject
Pediatrics, Perinatology, and Child Health
Cited by
3 articles.
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1. Lung Injury Caused by Pharmacologic Agents;Kendig & Chernickâs Disorders of the Respiratory Tract in Children;2012
2. Calcium Channel Antagonists;Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose;2007
3. Synopsis of the Most Important Biopharmaceutical Facts About Nifedipine/Adalat;Adalat;1991