Tricyclic antidepressant toxicity treated with massive sodium bicarbonate.
Tricyclic antidepressant (TCA) morbitity is primarily due to cardiac arrhythmias and hypotension, which become more refractory to treatment as acidosis progresses (Ann Emerg Med. 1985;14:1-9; Clin Toxicol. 2007;45:203-233; Flomenbaum N, Goldfrank L, Hoffman R, et al. Goldfrank's toxicologic emergencies. 8th ed. McGraw-Hill Companies, Inc, 2006). Early recognition and aggressive treatment are necessary for patient survival.
Pierog
Jessica E
JE
Lehigh Valley Hospital, Bethlehem, PA 18107, USA.
Kane
Kathleen E
KE
Kane
Bryan G
BG
Donovan
J Ward
JW
Helmick
Tracey
T
D000929:Antidepressive Agents, Tricyclic / Q000506:poisoning*; D001145:Arrhythmias, Cardiac / Q000139:chemically induced* / Q000175:diagnosis / Q000188:drug therapy*; D003511:Cyclohexanols / Q000506:poisoning*; D003891:Desipramine / Q000506:poisoning*; D062787:Drug Overdose; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008875:Middle Aged; D017693:Sodium Bicarbonate / Q000008:administration & dosage*; D000069470:Venlafaxine Hydrochloride
D000929:Antidepressive Agents, Tricyclic; D003511:Cyclohexanols; D000069470:Venlafaxine Hydrochloride; D017693:Sodium Bicarbonate; D003891:Desipramine