@article{ref1,
title="Amlodipine toxicity in children less than 6 years of age: a dose-response analysis using national poison data system data",
journal="Journal of emergency medicine",
year="2010",
author="Benson, Blaine E. and Spyker, D. A. and Troutman, William G. and Watson, William A. and Bakhireva, Ludmila N.",
volume="39",
number="2",
pages="186-193",
abstract="Background: Amlodipine is a long-acting calcium channel blocker capable of producing hypotension and dysrhythmia in overdose. The toxic doses of amlodipine in children are unclear. Objectives: The purposes of this study were to describe amlodipine poisoning in children and to determine whether a dose-response relationship could be detected in this population using standardized call data from United States (US) poison centers. Patients and Methods: 1251 amlodipine-only ingestions in children < 6 years of age were reviewed. Cases with doses coded as &quot;Exact&quot; or &quot;Estimated&quot; and with dose, age, and medical outcome were analyzed (n = 678). Ingestions reported as a &quot;taste or lick&quot; (n = 53) were included as a dose of 1/10 of the dosage form involved. A clinically important response was defined as bradycardia, hypotension, dysrhythmia, conduction disturbance, or hyperglycemia. The risk of such responses was examined over four dosage intervals (< 2.5 mg, 2.5-5 mg, 5.1-10 mg, and > 10 mg). Results: The median estimated dose ingested was 5 mg (range 0.25-200 mg). Clinically important responses developed in 27 patients (3.98%), and the prevalence of such response significantly increased from 0% for the lowest to 11.1% for the highest dose interval (p = 0.001). The smallest dose to produce a clinically important response was 2.5 mg (0.15 mg/kg). Children who ingested > 10 mg were 4.4 times more likely to develop clinically important responses than those ingesting </= 5 mg. Conclusion: Hypotension may occur in children with amlodipine doses as low as 2.5 mg. The National Poison Data System might provide useful insights regarding dose-response.<p /> <p>Language: en</p>",
language="en",
issn="0736-4679",
doi="10.1016/j.jemermed.2009.02.016",
url="http://dx.doi.org/10.1016/j.jemermed.2009.02.016"
}