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Captopril Overdose Resulting in Hypotension
W. Lynn Augenstein, MD;
Kenneth W. Kulig, MD;
Barry H. Rumack, MD
JAMA. 1988;259(22):3302-3305.
Abstract
We present a case in which a patient took an overdose of captopril (Capoten) and alprazolam (Xanax) in a suicide attempt. The patient presented with hypotension (systolic blood pressure of 80 mm Hg) and drowsiness. The hypotension initially responded to administration of intravenous fluids and dopamine; however, it recurred twice at 18.5 and 24.5 hours after ingestion. These episodes again responded to administration of fluids and dopamine. A plasma captopril level of 27 391.1 nmol/L (5982 ng/mL) was documented, as well as a depressed level of angiotensin converting enzyme. Captopril is an angiotensin converting enzyme inhibitor used in the management of hypertension and ventricular failure; to our knowledge, this is the first case of an acute captopril overdose reported in the English-language literature. The role of captopril in inducing hypotension is discussed herein.
(JAMA 1988;259:3302-3305)
Author Affiliations
From the Rocky Mountain Poison and Drug Center and the University of Colorado School of Medicine, Denver General Hospital.
Footnotes
This case was presented at the Annual Scientific Meeting of the American Academy of Clinical Toxicology, American Association of Poison Control Centers, American Board of Medical Toxicology, and Canadian Association of Poison Control Centers at Vancouver, British Columbia, Sept 29,1987.
Reprint requests to Rocky Mountain Poison Center, 645 Bannock St, Denver, CO 80204 (Dr Rumack).
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ABSTRACT
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HEMODYNAMIC EFFECTS PERSISTENT AFTER CAPTOPRIL OVERDOSE
JWatch General 1988;1988:8-8.
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