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A 47-year-old man developed emesis, obtundation, lactic acidosis, hypotension, increased work of breathing, tachypnoea, hypoxaemia, dilatation of the right ventricle, pulmonary oedema, acute kidney injury and decline in lung compliance following an overdose of lisinopril and amlodipine in a suicide attempt [times to reactions onsets not stated].
The man, who had arterial hypertension, attempted suicide with approximately 200mg of lisinopril and 400mg of amlodipine [routes not stated]. Subsequently, he presented to the hospital. He was found down and had several episodes of emesis during transport to the hospital. At presentation, he was found to be obtunded. Lab investigations were as follows: Glasgow coma scale 14, BP 60/40mm Hg, elevated serum creatinine, pH 7.24 and lactic acid level 8.4 mmol/L, consistent with lactic acidosis.
The man received treatment with crystalloid, norepinephrine, epinephrine, phenylephrine, dopamine, vasopressin and lipid emulsion. Additionally,...