Can you overdose on lisinopril
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Can You Overdose on Lisinopril?
Lisinopril, an angiotensin-converting enzyme (ACE) inhibitor, is commonly prescribed for conditions such as hypertension and heart failure. However, like any medication, it is possible to overdose on lisinopril, leading to serious health complications.
Symptoms and Complications of Lisinopril Overdose
Acute Kidney Injury and Metabolic Acidosis
One documented case involved a 51-year-old man who ingested 27 lisinopril tablets over a few days. This overdose led to severe complications, including high-anion-gap metabolic acidosis, acute kidney injury, severe hyperkalemia, and rhabdomyolysis. The patient exhibited symptoms such as incoherence, visual hallucinations, and inarticulate speech.
Blood Pressure Management Challenges
In another case, a patient with dilated cardiomyopathy experienced a lisinopril overdose that could not be managed with traditional vasopressors and intravenous fluids alone. This case required the use of intravenous angiotensin II to stabilize blood pressure, highlighting the potential severity of such overdoses.
Treatment and Management of Lisinopril Overdose
General Supportive Care
The primary approach to managing a lisinopril overdose includes general supportive care. This involves monitoring and stabilizing vital signs, ensuring adequate hydration, and addressing any immediate life-threatening symptoms .
Gut Decontamination
When possible, gut decontamination methods such as activated charcoal may be employed to limit further absorption of the drug from the gastrointestinal tract.
Intravenous Fluids and Vasopressors
Intravenous fluids are commonly used to support blood pressure. In cases where fluids alone are insufficient, vasopressors may be administered. However, as seen in some cases, traditional vasopressors may not always be effective, necessitating alternative treatments like intravenous angiotensin II.
Hemodialysis
In severe cases, hemodialysis may be required to remove lisinopril from the bloodstream. This was necessary in the case of the 51-year-old man, where hemodialysis helped resolve multiorgan dysfunction and corrected metabolic imbalances.
Conclusion
While lisinopril is an effective medication for managing hypertension and heart failure, an overdose can lead to severe and potentially life-threatening complications. Symptoms can range from metabolic acidosis and acute kidney injury to severe hyperkalemia and blood pressure instability. Treatment typically involves supportive care, gut decontamination, intravenous fluids, and in some cases, hemodialysis or intravenous angiotensin II. Prompt medical attention is crucial to manage and mitigate the effects of a lisinopril overdose.
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