[Cardiac arrhythmia in amitriptyline poisoning in children].
Amitriptyline (Antideprin) determines severe intoxications, especially because of its cardiac side effects.


METHODS
We studied 8 children (2-14 years old) admitted with signs of amitriptyline intoxication.


RESULTS
The clinical picture revealed altered general status, generalized hypertonia, arterial hypotension up to collapse, mydriasis, coma and cardiac arrhythmia. ECG monitoring showed ventricular premature beats, isolated, couplets and triplets, ventricular tachycardia and torsade des points, severe ventricular repolarisation disturbances with diffuse subendocardial ischemia. The treatment consisted in: gastric lavage with activated charcoal, alkalinisation with sodium bicarbonate, antiarrhythmic drugs and sustained vital functions. All cases recovered in 4-6 days.


CONCLUSIONS
The severity of amitriptyline intoxication requires continue clinical and ECG monitoring, for early detection of some life threatening cardiovascular events. Thus, the treatment will be started early and will alleviate the severe prognosis of this intoxication.
Streangă
Violeta
V
Universitatea de Medicină si Farmacie Gr.T. Popa Iaşi Facultatea de Medicină Clinica I Pediatrie.
Nistor
N
N
Dimitriu
A G
AG
Cristogel
F
F
Jităreanu
Cristina
C
Frasin
Mariana
M
D000293:Adolescent; D000639:Amitriptyline / Q000506:poisoning*; D000889:Anti-Arrhythmia Agents / Q000627:therapeutic use; D000929:Antidepressive Agents, Tricyclic / Q000506:poisoning*; D001145:Arrhythmias, Cardiac / Q000139:chemically induced* / Q000628:therapy; D002021:Buffers; D002606:Charcoal / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D004359:Drug Therapy, Combination; D004562:Electrocardiography; D005751:Gastric Lavage; D006801:Humans; D012189:Retrospective Studies; D017693:Sodium Bicarbonate / Q000627:therapeutic use; D016896:Treatment Outcome
D000889:Anti-Arrhythmia Agents; D000929:Antidepressive Agents, Tricyclic; D002021:Buffers; D002606:Charcoal; D000639:Amitriptyline; D017693:Sodium Bicarbonate