Reversal of severe tricyclic antidepressant-induced cardiotoxicity with intravenous hypertonic saline solution

Annals of Emergency Medicine

Volumn 42, Issue 1, 2003, Pages 20-24

  McKinney, Patrick E ^a,b   Rasmussen, Robin ^a  

^a UNIVERSITY OF NEW MEXICO HEALTH SCIENCES CENTER   (United States)

^b UNIVERSITY OF NEW MEXICO   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ANTIDEPRESSANT AGENT; BICARBONATE; DOPAMINE; NORADRENALIN; NORTRIPTYLINE; SODIUM CHLORIDE; TRICYCLIC ANTIDEPRESSANT AGENT;

ADULT; ARTERIAL PH; ARTICLE; BOLUS INJECTION; CARDIOTOXICITY; CASE REPORT; COMA; ELECTROCARDIOGRAM; FEMALE; HEART VENTRICLE EXTRASYSTOLE; HUMAN; HYPERVENTILATION; HYPOTENSION; INTUBATION; PRIORITY JOURNAL; QT INTERVAL; STOMACH LAVAGE;

EID: 0038016854     PISSN: 01960644     EISSN: None     Source Type: Journal    
DOI: 10.1067/mem.2003.233     Document Type: Article

References (14)

1. Litovitz TL, Klein-Schwartz W, White S, et al. The 2000 Annual Report of the Association of Poison Control Centers Toxic Exposure Surveillance System. Am J Emerg Med. 2001;19:337-395.
2. Smilkstein MJ. Reviewing cyclic antidepressant cardiotoxicity: wheat from chaff. J Emerg Med. 1990;8:645-648.
3. Sasyniuk BI, Jhamandas V. Mechanism of reversal of toxic effects of amitriptyline on cardiac Purkinie fibers by sodium bicarbonate. J Pharmacol Exp Ther. 1984;231:387-394.
4. Sasyniuk BI, Jhamandas V, Valois M. Experimental amitriptyline intoxication: treatment of cardiac toxicity with sodium bicarbonate. Ann Emerg Med. 1986;15:1052-1059.
5. Wrenn K, Smith BA, Slovis CM. Profound alkalemia during treatment of tricyclic antidepressant overdose: a potential hazard of combined hyperventilation and intravenous bicarbonate. Am J Emerg Med. 1992;10:553-555.
6. Vassar MJ, Perry CA, Gannaway WL, et al. 7.5% sodium chloride/dextran for resuscitation of trauma patients undergoing helicopter transport. Arch Surg. 1991;126:1065-1072.
7. McCabe JL, Menegazzi JJ, Cobaugh DJ, et al. Recovery from severe cyclic antidepressant overdose with hypertonic saline/dextran in a swine model. Acad Emerg Med. 1994;1:111-115.
8. McCabe JL, Cobaugh DJ, Menegazzi JJ, et al. Experimental tricyclic antidepressant toxicity: a randomized, controlled comparison of hypertonic saline soluti, sodium bicarbonate, and hyperventilation. Ann Emerg Med. 1998;1:329-333.
9. Pentel P, Benowitz N. Efficacy and mechanism of action of sodium bicarbonate in the treatment of desipramine toxicity in rats. J Pharmacol Exp Ther. 1984;230:12-19.
10. Høegholm A, Clementsen P. Hypertonic sodium chloride in severe antidepressant overdosage. J Toxicol Clin Toxicol. 1991;29:297-298.
11. Dolara P, Franconi F. Hypertonic sodium chloride and lidocaine in a case of imipramine intoxication. J Toxicol Clin Toxicol. 1977;10:395-398.
12. Seitz R, Wehr M, Pallmert N. Arrhythmien bei vergiftungdurch trizyklische antidepressiva: Erfolgreiche behandlung mit physostigmin und natrium. Dtsch Med Wochenschr. 1982;107:1096-1099.
13. Nattel S, Mittleman M. Treatment of ventricular tachyarrythmias resulting from amitriptyline toxicity in dogs. J PharmacolExp Ther. 1984;231:430-435.
14. Nattel S, Keable H, Sasyniuk BI. Experimental amitriptyline intoxication: electrophysiologic manifestations and management. J Cardiovasc PharmacoL 1984;6:83-89.