title: Case reports of successful therapeutic plasma exchange in severe amitriptyline poisoning.
abstract: Severe amitriptyline toxicity may cause coma, hypotension, convulsions, supraventricular and ventricular arrhythmias, metabolic/respiratory acidosis and cardiac arrest. Management with gastric lavage, activated charcoal, alkalinization with sodium bicarbonate and supportive care with mechanical ventilation, antiarrhythmics and anticonvulsants if required, is the common approach. Herein, we report successful treatment of severe amitriptyline poisoning in three cases by plasma exchange in addition to the above supportive measures. Plasma exchange may have a beneficial role in lethal doses of amitriptyline ingestion because of the high plasma protein binding property of amitriptyline.
authors.affiliation: Hacettepe University, Division of Pediatric Intensive Care Unit, Ankara, Turkey.
authors.forename: Benan
authors.initials: B
authors.lastname: Bayrakci
authors.forename: Sule
authors.initials: S
authors.lastname: Unal
authors.forename: Mustafa
authors.initials: M
authors.lastname: Erkocoglu
authors.forename: Handan Yüksel
authors.initials: HY
authors.lastname: Güngör
authors.forename: Salih
authors.initials: S
authors.lastname: Aksu
mesh_terms: D000293:Adolescent; D000639:Amitriptyline / Q000506:poisoning*; D005260:Female; D006801:Humans; D010951:Plasma Exchange / Q000379:methods*
chemical_list: D000639:Amitriptyline