Hyperinsulinemic Euglycemia Therapy for Acute Nitroglycerin Poisoning: Case Report
Nitroglycerin, a vasodilator, is commonly administered to treat ischemic heart disease. Adverse effects after toxicity are light-headedness, nausea, blurry vision, and syncope due to low systolic blood pressure as well as methemoglobinemia. A 19-year-old female was admitted to our toxicology departm...
| Published in: | International Journal of Medical Toxicology and Forensic Medicine |
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| Main Authors: | , , |
| Format: | Article |
| Language: | English |
| Published: |
Shaheed Beheshti University of Medical Sciences
2022-05-01
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| Subjects: | |
| Online Access: | https://journals.sbmu.ac.ir/ijmtfm/article/view/37176 |
| Summary: | Nitroglycerin, a vasodilator, is commonly administered to treat ischemic heart disease. Adverse effects after toxicity are light-headedness, nausea, blurry vision, and syncope due to low systolic blood pressure as well as methemoglobinemia. A 19-year-old female was admitted to our toxicology department after suicidal ingestion of 320 mg extended-release nitroglycerin about 45 minutes before the admission. She was conscious, and her initial blood pressure was 98/65 mm Hg, which was decreased to 77 mmHg within 1.5 hours despite administration of 1 liter of normal saline. Due to severe hypotension, norepinephrine infusion was started for systolic blood pressure maintenance above 80mm Hg; however, she started complaining of palpitation and chest pain. So, the dose of norepinephrine was reduced, and glucose, insulin, and potassium protocol were started. After 3 hours of therapy, her hemodynamic condition stabilized with systolic blood pressure above 90mm Hg; hence norepinephrine was discontinued. She was discharged on the 3rd day after the psychiatric consultation, with regular clinical and paraclinical examinations. |
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| ISSN: | 2251-8762 2251-8770 |