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Keywords "Overdose" AND ("Tricyclic Ant...

"Overdose" AND ("Tricyclic Antidepressant" OR "TCA") AND "Sodium Bicarbonate" AND "QRS"

https://read.qxmd.com/read/3784839/tricyclic-antidepressant-poisoning-management-of-arrhythmias
#21
JOURNAL ARTICLE
P R Pentel, N L Benowitz
Deaths from tricyclic antidepressant (TCA) overdose are usually due to arrhythmias and/or hypotension. Tricyclic antidepressant toxicity is due mainly to the quinidine-like actions of these drugs on cardiac tissues. Slowing of phase 0 depolarisation of the action potential results in slowing of conduction through the His-Purkinje system and myocardium. Slowed impulse conduction is responsible for QRS prolongation and atrioventricular block, and contributes to ventricular arrhythmias and hypotension. Therapies that improve conduction, e...
March 1986: Medical Toxicology
https://read.qxmd.com/read/3515300/tricyclic-antidepressant-overdose
#22
REVIEW
N J Braden, J E Jackson, P D Walson
Overdose of a tricyclic antidepressant is a serious and all-too-frequent occurrence. The diagnosis must be considered in known or suspected overdoses, and signs such as a dry axilla, tachycardia, and wide QRS must be specifically sought. Management depends upon support of vital functions and a thorough understanding of the pharmacology of the drug. Emptying the gastrointestinal tract with ipecac or lavage and hastening elimination with activated charcoal and a cathartic are extremely important measures. Cardiac arrhythmias generally respond to sodium bicarbonate, and seizures respond to intravenous diazepam...
April 1986: Pediatric Clinics of North America
https://read.qxmd.com/read/3017159/experimental-amitriptyline-intoxication-treatment-of-cardiac-toxicity-with-sodium-bicarbonate
#23
JOURNAL ARTICLE
B I Sasyniuk, V Jhamandas, M Valois
Overdose with amitriptyline and other tricyclic antidepressants can result in ventricular conduction abnormalities as well as severe ventricular arrhythmias. The arrhythmogenic effects of these compounds may be attributed to their direct local anesthetic actions in blocking sodium channels in cardiac membranes. Thus tricyclic-induced ventricular arrhythmias usually do not respond well to therapy with standard Class I antiarrhythmic drugs that also have the same direct local anesthetic action and may potentiate the adverse effects of tricyclic antidepressants...
September 1986: Annals of Emergency Medicine
https://read.qxmd.com/read/2254609/the-electrocardiographic-manifestations-of-cyclic-antidepressant-therapy-and-overdose-a-review
#24
REVIEW
G Groleau, R Jotte, R Barish
Cyclic antidepressants may cause changes in the electrocardiogram at therapeutic or toxic serum levels. The most serious complications of cyclic antidepressant toxicity are dysrhythmias, hypotension, and seizures. It is predominantly the cardiotoxic effects that cause mortality. Once cardiotoxicity is evident, the treatment of choice is serum alkalinization, preferably by sodium bicarbonate therapy. In order to predict which overdose patients are at high risk for complications, electrocardiographic criteria have been identified as reliable screens...
September 1990: Journal of Emergency Medicine
https://read.qxmd.com/read/1621627/managing-tricyclic-antidepressant-overdose
#25
REVIEW
L M Haddad
Tricyclic antidepressant overdose is the most common cause of death from prescription drugs. Clinical presentation of overdose from the tricyclic agents includes cardiac arrhythmias, hypotension, seizures, coma and anticholinergic signs such as hyperthermia, flushing and intestinal ileus. The highly toxic/lethal level (greater than 1,000 ng per mL) is manifested on electrocardiograms as prolongation of the QRS interval to 100 milliseconds or more. Treatment includes establishment of an airway, proper oxygenation and ventilation, fluid replacement at maintenance levels, cardiac monitoring, gastric lavage and charcoal administration, alkalinization to a blood pH of 7...
July 1992: American Family Physician
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