Case Report
Prolonged Refractory Hypotension following Combined Amlodipine and Losartan Ingestion Responsive to Metaraminol
Table 1
Initial effect of metaraminol boluses.
| Time since admission to ED in hours | Metaraminol bolus of 0.5 mg | Systolic | Diastolic | MAP | Pulse |
| In ED | | 122 | 61 | 81 | 100 | In ED 1 hour after admission | | 70 | 40 | 50 | 90 | Taken from medical SHO clerking 3 hours after admission | | 75 | 43 | 54 | 96 | 5 when first seen by ICU | | 80 | 50 | 63 | 98 | 5 given metaraminol in boluses at intervals of 5–10 minutes. | 0.5 mg + 0.5 mg | 72 | 46 | 55 | 99 | 5:20 | | 110 | 68 | 82 | 89 | 5 then given calcium gluconate (20 mLs of 10%) followed by glucagon 10 mg as a bolus | 0.5 mg + 0.5 mg | 125 | 62 | 84 | 100 | 5:30 | | 120 | 74 | 89 | 86 | 6 | | 90 | 50 | 63 | 85 | 7 noradrenaline started here | | 70 | 48 | 55 | 85 | 8 | | 75 | 43 | 54 | 85 | 9 | | 80 | 48 | 59 | 85 | 10 | | 90 | 55 | 67 | 85 | 11—admitted to ICU- vasopressin started here along with glucagons infusion | | 85 | 47 | 60 | 95 | 12 adrenaline started here | | 95 | 50 | 65 | 80 |
|
|