Absence of hyperdynamic contractility in the setting of amlodipine-induced shock.

Amlodipine is a commonly prescribed antihypertensive, and among the calcium channel blockers is associated with the most fatalities in the United States. Vasoplegic shock secondary to dihydropyridine overdose is typically managed with intravenous fluids, calcium replacement and vasopressors. While high dose insulin (HDI) has established efficacy in non-dihydropyridine calcium channel blocker induced cardiogenic shock, utility in amlodipine toxicity remains controversial.