Fosinopril overdosage: Difference between revisions
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==Overdosage== | |||
Oral doses of fosinopril at 2600 mg/kg in rats were associated with significant lethality. Human overdoses of fosinopril have not been reported, but the most common manifestation of human fosinopril overdosage is likely to be [[hypotension]]. | |||
Laboratory determinations of serum levels of fosinoprilat and its metabolites are not widely available, and such determinations have, in any event, no established role in the management of fosinopril overdose. No data are available to suggest physiological maneuvers (e.g., maneuvers to change the pH of the urine) that might accelerate elimination of fosinopril and its metabolites. Fosinoprilat is poorly removed from the body by both [[hemodialysis]] and [[peritoneal dialysis]]. | |||
<ref name="dailymed.nlm.nih.gov">{{Cite web | last = | first = | title = FOSINOPRIL NA (FOSINOPRIL SODIUM) TABLET [APOTEX CORP.] | url = http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=eaa753e8-9fda-af0b-9d54-bdf0d1674832 | publisher = | date = | accessdate = }}</ref> | [[Angiotensin II]] could presumably serve as a specific antagonist-antidote in the setting of fosinopril overdose, but angiotensin II is essentially unavailable outside of scattered research facilities. Because the hypotensive effect of fosinopril is achieved through vasodilation and effective [[hypovolemia]], it is reasonable to treat fosinopril overdose by infusion of normal saline solution. | ||
No adverse clinical events were reported in 23 pediatric patients, age 6 months to 6 years, given a single 0.3 mg/kg oral dose of fosinopril. | |||
There is a published report of a 20 month-old female, weighing 12 kg, who ingested approximately 200 mg fosinopril. After receiving gastric lavage and activated [[charcoal]] within one hour of the ingestion, she made an uneventful recovery.<ref name="dailymed.nlm.nih.gov">{{Cite web | last = | first = | title = FOSINOPRIL NA (FOSINOPRIL SODIUM) TABLET [APOTEX CORP.] | url = http://dailymed.nlm.nih.gov/dailymed/lookup.cfm?setid=eaa753e8-9fda-af0b-9d54-bdf0d1674832 | publisher = | date = | accessdate = }}</ref> | |||
==References== | ==References== | ||
Revision as of 17:30, 13 February 2014
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Amr Marawan, M.D. [2], Ahmed Zaghw, M.D. [3]
Fosinopril
Fosinopril and Hydrochlorothiazide
Overview
Captopril tablet is an angiontensin converting enzyme inhibitor drug that is FDA approved for the treatment of hypertension, heart failure, left ventricular dysfunction after myocardial infarction, diabetic nephropathy. Adverse reactions include hypotension, rash, hyperkalemia, disorder of taste, cough. hypotension, rash, hyperkalemia, disorder of taste, cough.
Category
Antihypertensive Agents, Angiotensin Converting Enzyme Inhibitors. Editor-In-Chief: C. Michael Gibson, M.S., M.D. [4]; Associate Editor(s)-in-Chief: Amr Marawan, M.D. [5]
Overdosage
Oral doses of fosinopril at 2600 mg/kg in rats were associated with significant lethality. Human overdoses of fosinopril have not been reported, but the most common manifestation of human fosinopril overdosage is likely to be hypotension.
Laboratory determinations of serum levels of fosinoprilat and its metabolites are not widely available, and such determinations have, in any event, no established role in the management of fosinopril overdose. No data are available to suggest physiological maneuvers (e.g., maneuvers to change the pH of the urine) that might accelerate elimination of fosinopril and its metabolites. Fosinoprilat is poorly removed from the body by both hemodialysis and peritoneal dialysis.
Angiotensin II could presumably serve as a specific antagonist-antidote in the setting of fosinopril overdose, but angiotensin II is essentially unavailable outside of scattered research facilities. Because the hypotensive effect of fosinopril is achieved through vasodilation and effective hypovolemia, it is reasonable to treat fosinopril overdose by infusion of normal saline solution.
No adverse clinical events were reported in 23 pediatric patients, age 6 months to 6 years, given a single 0.3 mg/kg oral dose of fosinopril.
There is a published report of a 20 month-old female, weighing 12 kg, who ingested approximately 200 mg fosinopril. After receiving gastric lavage and activated charcoal within one hour of the ingestion, she made an uneventful recovery.[1]
References
Adapted from the FDA Package Insert.