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| __NOTOC__
| | #REDIRECT [[Nifedipine#Overdosage]] |
| {{Nifedipine}}
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| {{CMG}}; {{AE}}: {{AK}}
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| '''''For patient information about Nifedipine, click [[Nifedipine (patient information)|here]].'''''
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| ==OVERDOSAGE==
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| Experience with nifedipine overdosage is limited. Generally, overdosage with nifedipine leading to pronounced [[hypotension]] calls for active cardiovascular support including monitoring of cardiovascular and respiratory function, elevation of extremities, judicious use of calcium infusion, pressor agents and fluids. Clearance of nifedipine would be expected to be prolonged in patients with impaired liver function. Since nifedipine is highly protein-bound, dialysis is not likely to be of any benefit.
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| There has been one reported case of massive overdosage with nifedipine extended-release tablets. The main effects of ingestion of approximately 4800 mg of nifedipine extended-release in a young man attempting suicide as a result of cocaine-induced depression was initial dizziness, palpitations, [[flushing]], and [[nervousness]]. Within several hours of [[ingestion]], [[nausea]], [[vomiting]], and [[generalized edema]] developed. No significant hypotension was apparent at presentation, 18 hours post-ingestion. Electrolyte abnormalities consisted of a mild, transient elevation of serum creatinine, and modest elevations of LDH and CPK, but normal SGOT. Vital signs remained stable, no electrocardiographic abnormalities were noted and renal function returned to normal within 24 to 48 hours with routine supportive measures alone. No prolonged sequelae were observed.
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| The effect of a single 900 mg ingestion of nifedipine immediate-release capsules in a depressed anginal patient also on [[tricyclic antidepressants]] was [[loss of consciousness]] within 30 minutes of ingestion, and profound hypotension, which responded to calcium infusion, pressor agents, and fluid replacement. A variety of ECG abnormalities were seen in this patient with a history of [[bundle branch block]], including [[sinus bradycardia]] and varying degrees of [[AV block]]. These dictated the prophylactic placement of a temporary [[ventricular pacemaker]], but otherwise resolved spontaneously. Significant [[hyperglycemia]] was seen initially in this patient, but plasma glucose levels rapidly normalized without further treatment.
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| A young hypertensive patient with advanced [[renal failure]] ingested 280 mg of nifedipine immediate-release capsules at one time, with resulting marked hypotension responding to calcium infusion and fluids. No AV conduction abnormalities, arrhythmias, or pronounced changes in heart rate were noted, nor was there any further deterioration in renal function.
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| ==References==
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| {{Reflist|2}}
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| http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=03be089c-07e5-4f94-bfcc-c6101b311785
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| [[Category:Cardiovascular Drugs]]
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| [[Category:Drugs]]
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