Enalapril: overdose fatal dose

Enalapril is a drug that reduces blood pressure. He was appointed on a permanent basis to patients with elevated blood pressure parameters to reduce the risk of strokes and heart attacks, after heart attacks, kidney disease and diabetes. An overdose of enalapril is rare because the drug is well tolerated by patients.

The mechanism of action of the drug on the body

The medication is well studied and widely applicable in therapeutic practice. Enalapril inhibits the enzyme that causes vasoconstriction and increased pressure in them. Under the action of the drug increases cardiac output, reduced vascular resistance, decreases systolic and diastolic blood pressure. Significantly reduced load on the myocardium. The drug is concentrated in plasma, at this moment reached the maximum therapeutic effect.

Enalapril has the following properties:

  • diuretic effect (diuretic) reduces vnutrikletochnogo pressure in the kidneys, prevents the development of chronic renal failure;
  • improves blood circulation in the body;
  • prevents the development of pathological processes in the cardiac muscle, the kidneys, blood vessels;
  • normalizes the exchange of blood.

Permissible doses enalapril does not affect the blood circulation in the brain, the blood flow to the brain does not prevent. The sudden removal does not cause sharp increase in blood pressure. Drug action in the body lasts for hours. It is prescribed after failure of other hypotensive drugs.

A single dose does not exceed 0.02 g Maximum daily dose of 0.04 g. Lethal dose is not established.

The drug is excreted by the kidneys (60%) and gastrointestinal (40%).

Signs of an overdose of enalapril

The main effects of poisoning with enalapril severe and are manifested by disruption of the heart, blood vessels and nervous system.

Symptoms of overdose of the cardiovascular system:

  • low blood pressure;
  • violation of of heart rhythms (atrial fibrillation) – chaotic activity of the heart chambers;
  • angina;
  • the development of myocardial infarction – coronary thrombosis, which leads to oxygen starvation of the heart muscle and its necrosis (death);
  • orthostatic hypotension – drop in pressure until the development of collapse.

Symptoms of poisoning the nervous system:

  • CNS depression;
  • sleeplessness or drowsiness;
  • violation of the senses: taste, smell, sight, hearing (tinnitus);
  • inflammation of the mucous membrane of the eye; tearing;
  • apathy alternating with depression;
  • peripheral neuropathy – impaired transmission of nerve impulses from the organs to the brain;
  • cramps;
  • acute violation of cerebral circulation.

Overdose drug affects the respiratory system. The victim begins shortness of breath and dry cough which does not bring relief. Liberally mucus from the nose. Develop bronchitis affects the alveoli in the lungs. There may come a spasm of the bronchi.

Symptoms of poisoning with enalapril from the digestive system:

  • inflammation of the oral mucosa;
  • dry mouth, lack of salivation;
  • inflammation of the tongue;
  • dyspepsia, nausea, bloating, gas, semi-liquid stool black;
  • pancreatitis – inflammation of the pancreas;
  • the disruption of the liver – hepatitis, necrosis of liver cells (liver cells).

Because of the large concentration of enalapril in the blood of impaired functionality of the kidneys. Decreasing the daily amount of urine, joining infection of the urinary tract. In men, an overdose of the drug leads to sexual dysfunction and impotence. Can cause gynecomastia is an inflammation of the breast.

Poisoning with enalapril increases the body's sensitivity and enhances the manifestation of local and General allergic reactions:

  • exfoliative dermatitis;
  • pemphigus;
  • shingles;
  • photodermatitis Allergy to sunlight;
  • urticaria;
  • hair loss.

In severe cases, anaphylactic shock develops.

First aid for poisoning, treatment of overdosage with enalapril

The victim must be in a horizontal position. If the person feels well shown gastric lavage a weak saline solution. At home cause an artificial vomiting, the hospital conducted a lavage tube. Then assign any of the adsorbents is activated charcoal or white charcoal, POLYSORB, smectite.

To neutralize enalapril antidote exists. Treatment is aimed at restoring water-salt balance and eliminate the symptoms.

Hydration therapy is conducted with the aim of restoring electrolyte and water in the body. To do this, intravenously administered solution of sodium chloride 0,9% (saline) glucose 5%.

Symptomatic treatment of overdose enalapril:

  • to support the work of the heart – cardiac glycosides;
  • to restore the psycho-emotional state, sleep – sedative (anti-anxiety) drugs;
  • to maintain the liver and prevent its destruction – hepatoprotectors;
  • diarrhea – anti-diarrhea;
  • nausea and heartburn – antaciddrugs;
  • to maintain the pancreas – pancreatic enzymes;
  • to eliminate pain – antispasmodics;
  • for the prevention and treatment of bacterial kidney infection – antibiotics;
  • in allergic skin lesions – antihistamines, hormonal ointments.

If the kidney damage, inflammation and violation of functionality shown hemodialysis – blood purification through the apparatus from toxic substances and saturation of useful microelements.

In severe cases such as stroke, anaphylactic shock, heart attack attack carried out resuscitation.

Do not take enalapril, spirits, immunosuppressants and cytostatics (chemotherapy). These drugs work synergistically with each other and can cause symptoms of poisoning.

The treatment is carried out under constant control of blood pressure, blood counts and urine tests, electrocardiogram.

During the initial drug prescribed minimum dose and monitor the condition and response of the patient. This allows you to avoid overdose of the medicine.

To avoid overdose with amlodipine, need to comply with the prescribed dosage and time of drug intake to monitor the shelf life. You can not use damaged, wet, expired pills.

A serious overdose of medication, life-threatening, is extremely rare. For fifty years enalapril remains the most effective means to deal with blood pressure. The drug goes by various commercial names: anipryl, enam, anulator, vasolapril, renipril.