Tox Tute 001 Tricyclic Antidepressant Overdose
A young male is unconscious and on his way to your hospital. Bystanders confirm he has been depressed and taken an overdose. The paramedics are worried about his ECG…”it looks weird and his QRS is very wide”. The following tox tute will guide you through managing this patient.
ECG on arrival
Tox Tute TCA Basic
+ Tox Tute AUDIO – TCA Overdose – Quick Version
expand(document.getElementById('ddet872606588'));expand(document.getElementById('ddetlink872606588'))
Tox Tute TCA Advanced
+ AUDIO TCAs Overdose
expand(document.getElementById('ddet1105041190'));expand(document.getElementById('ddetlink1105041190'))
+ Pharmacology of TCAs BSCC video
expand(document.getElementById('ddet1203820510'));expand(document.getElementById('ddetlink1203820510'))
+ TCAs and the ECG video
expand(document.getElementById('ddet1357678463'));expand(document.getElementById('ddetlink1357678463'))
Essential Knowledge
Key TCA knowledge:
>10mk/kg is potentially life threatening
Severe toxicity usually manifests within 2 hours
QRS widens due to fast sodium channel blockade, >100ms is predictive of seizures and >160ms is predictive of ventricular tachycardia
The mainstay of treatment for severe toxicity involves aggressive supportive care including the use of sodium bicarbonate for dysrhythmias and widening of the QRS alongside hyperventilation to maintain a pH >7.5-7.55
Additional Resources
Toxicology Library
Tricyclic Anti-depressants (TCAs) Page
...
Source: Life in the Fast Lane - Category: Emergency Medicine Authors: Neil Long Tags: Tox Tutes TCA TCA overdose TCAs toxicology tricyclic antidepressant Tricyclic Antidepressant Overdose Source Type: blogs
More News: Blogging | Databases & Libraries | Depression | Drugs & Pharmacology | Emergency Medicine Doctors | Hospitals | Overdose | Toxicology | Ventricular Tachycardia