Severe Calcium Channel Blocker Toxicity Treated with CytoSorb Hemoadsorption and Supportive Therapies: A Case Study

CASE REPORT(200 mg) of amlodipine-a dihydropyridine CCB-1 day prior.She subsequently developed nausea, vomiting, vertigo, and decreased urine output.Initially admitted to a local hospital, she was transferred to a higher center due to the potential need for extracorporeal membrane oxygenation (ECMO) and renal replacement therapy (RRT).Her medical history included depression over the past 2 months, for which she had been on antidepressant therapy (escitalopram 5 mg once daily + etizolam 0.25 mg as and when required). IntroductIonCalcium channel blockers (CCBs) are categorized into two types: dihydropyridines, such as amlodipine, nicardipine, and nimodipine, and nondihydropyridines, including verapamil and diltiazem.They are commonly used as first-line treatments for hypertension and angina.CCBs primarily act by blocking L-type calcium channels, which results in the relaxation of vascular smooth muscles and subsequent vasodilation. 1Frequently reported side effects include swelling, lightheadedness, skin flushing, palpitations, nausea, and abdominal discomfort.Consuming large amounts of CCBs can result in severe cardiovascular complications, such as significant hypotension and damage to vital organs, including seizures, myocardial infarction, acute respiratory distress syndrome (ARDS), kidney failure, bowel infarction, and stroke. 2 Reports on CCB overdose cases are limited in the Indian medical literature. 3 Here, we present a case of CCB toxicity promptly identified by an intensive critical care specialist using telemedicine technology and managed by a multidisciplinary team with combined pharmacological interventions and hemodialysis using a CytoSorb device, leading to a favorable outcome. case descrI p t I o nA previously healthy 32-year-old woman presented at the emergency department with a history of ingesting approximately 40 tablets 1,