A Survival Case of High-Dose Amlodipine Intoxication With Unusual Manifestation of Type 2 Respiratory Failure

TL;DR

A 17-year-old survived a high-dose amlodipine overdose with unusual type 2 respiratory failure and recovered after intensive treatment.

Contribution

This case highlights the rare but severe complication of type 2 respiratory failure from amlodipine overdose.

Findings

The patient developed type 2 respiratory failure requiring mechanical ventilation.

Full recovery was achieved with fluid resuscitation, calcium, insulin therapy, and supportive care.

Early detection and management are critical for severe amlodipine toxicity.

Abstract

Amlodipine, a calcium channel blocker of the dihydropyridine class, is frequently used to treat high blood pressure. While overdoses are rare, they can result in significant cardiovascular compromise and, infrequently, respiratory failure. We report the case of a 17-year-old male patient who presented with an intentional amlodipine overdose, and his clinical course was complicated by type 2 (hypercapnic) respiratory failure, necessitating mechanical ventilation and intensive care management. He achieved full recovery with fluid resuscitation, calcium supplementation, high-dose insulin euglycemic therapy, vasopressor support, lung-protective ventilation, and supportive therapy. This case report highlights the importance of early detection and timely management of amlodipine toxicity, which can lead to severe complications such as cardiovascular instability, fluid overload, and respiratory distress with type 2 respiratory failure.

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