Combination of Angiotensin II Receptor Antagonist with Calcium Channel Blocker or Diuretic as Antihypertensive Therapy for Patients with Chronic Kidney Disease

2011 ◽  
Vol 33 (6) ◽  
pp. 366-372 ◽  
Author(s):  
Toshihiko Ishimitsu ◽  
Eri Ohno ◽  
Nobuyuki Nakano ◽  
Satoshi Furukata ◽  
Akira Akashiba ◽  
...  
2009 ◽  
Vol 32 (11) ◽  
pp. 962-968 ◽  
Author(s):  
Toshihiko Ishimitsu ◽  
Atsushi Numabe ◽  
Toshihide Masuda ◽  
Tomoyuki Akabane ◽  
Atsushi Okamura ◽  
...  

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
James O. M. Plumb ◽  
Craig Stewart ◽  
Michael Eddleston ◽  
Thearina de Beer

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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