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Citation |
Jan M, Brothers E, Nakagawa TA. Transl. Pediatr. 2021; 10(9): 2398-2401. |
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Copyright |
(Copyright © 2021, AME Publishing) |
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DOI |
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PMID |
unavailable |
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Abstract |
Midodrine is an antihypotensive agent used primarily in the adult population for orthostatic hypotension and reflex syncope, postural orthostatic tachycardia syndrome (POTS), and hemodialysis-induced hypotension. Limited information about midodrine ingestion and overdose exists in children with only a single case series reported in the literature. Varying presentations of midodrine ingestion in children have not been shown to be acutely life-threatening in doses up to 50 mg. We present a case of a 12-year-old who intentionally ingested 100 mg of midodrine and presented with a hypertensive emergency and seizure activity. This is the largest reported dose ingested in a child. The patient was observed and treated with a nicardipine infusion in the pediatric intensive care unit (PICU). Prompt identification and treatment of symptoms contributed to a favorable outcome with no neurologic deficits and complete recovery from an intentional ingestion of midodrine. Mechanism, duration of action, and management of midodrine ingestion including treatment for a hypertensive emergency in children are discussed. Commonly used pharmacologic agents to treat hypertension are reviewed. This case report of a significant ingestion of midodrine reviews management of hypertensive emergencies and provides information and guidance to healthcare professionals unfamiliar with this medication and its potentially fatal effects. © 2021 AME Publishing Company. All rights reserved. Language: en |
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Keywords |
human; child; female; case report; Overdose; emergency; suicide attempt; drug overdose; school child; clinical article; patient monitoring; headache; emergency ward; Seizure; tonic clonic seizure; nausea; lorazepam; hypertension; clinical observation; Hypertension; ketorolac; Emergency; Article; drug dose titration; ondansetron; nicardipine; pediatric intensive care unit; postural orthostatic tachycardia syndrome; midodrine; Midodrine |