PEDIATRICS Vol. 86 No. 1 July 1990, pp. 91-94
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Nifedipine Poisoning in a Child

Thomas G. Wells MD1, Charles J. Graham MD1, M. Michele Moss MD1, and Gregory L. Kearns PharmD1

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

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.

Key Words: nifedipine poisoning




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