title: Cardiotoxicity of tricyclic antidepressant treated by 2650 mEq sodium bicarbonate: A case report.
abstract: Poisoning with tricyclic antidepressants is an important cause of drug-related self-poisoning in the developed world and a very common cause of poisoning and mortality in developing countries. Electrocardiographic manifestations of most tricyclic antidepressant-poisoned patients resolve by the administration of 1-2 mEq/kg of sodium bicarbonate. Some rare cases have been reported who have been resistant to the long-term or high doses of bicarbonate administration. We present a case of acute tricyclic antidepressant toxicity referring with status epilepticus, hypotension, and refractory QRS complex widening that resolved after the intravenous administration of 2650 mEq sodium bicarbonate.
authors.affiliation: Emergency Medicine Management Research Center, Iran University of Medical Sciences, Tehran, Iran; Toxicological Research Center, Loghman-Hakim Hospital, Department of Clinical Toxicological, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
authors.forename: Hassan
authors.initials: H
authors.lastname: Amiri
authors.affiliation: Toxicological Research Center, Loghman-Hakim Hospital, Department of Clinical Toxicological, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Excellence Center of Clinical Toxicology, Iranian Ministry of Health, Tehran, Iran.
authors.forename: Nasim
authors.initials: N
authors.lastname: Zamani
authors.affiliation: Toxicological Research Center, Loghman-Hakim Hospital, Department of Clinical Toxicological, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Excellence Center of Clinical Toxicology, Iranian Ministry of Health, Tehran, Iran.
authors.forename: Hossein
authors.initials: H
authors.lastname: Hassanian-Moghaddam
authors.affiliation: Toxicological Research Center, Loghman-Hakim Hospital, Department of Clinical Toxicological, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Excellence Center of Clinical Toxicology, Iranian Ministry of Health, Tehran, Iran.
authors.forename: Shahin
authors.initials: S
authors.lastname: Shadnia
keywords: Tricyclic antidepressants; bicarbonate therapy; cardiotoxic drugs; deliberate self-harm; poisoning