Abstract
Background
Angiotensin-converting enzyme (ACE) inhibitor overdose is an uncommonly presenting
toxicologic emergency. Management is primarily supportive care, but a small body of
evidence exists to support naloxone for management of hypotension.
Case Report
We present a case of accidental ACE inhibitor overdose. The patient took approximately
300 mg lisinopril over 48 h and presented for evaluation of syncope. He was hypotensive
and unresponsive to fluids. We administered naloxone with immediate and sustained
resolution in hypotension. The mechanism of action is briefly discussed.
Why Should an Emergency Medicine Physician Be Aware of This? Naloxone is a rapid,
low-risk, low-cost, and effective intervention for hypotension due to ACE inhibitor
toxicity. It is supported by basic science research and clinical experience.
Keywords
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Article info
Publication history
Published online: December 25, 2022
Accepted:
December 13,
2022
Received in revised form:
September 26,
2022
Received:
May 3,
2022
Publication stage
In Press Uncorrected ProofIdentification
Copyright
© 2022 Elsevier Inc. All rights reserved.
