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This article reviews lavage cases called in to a state poison center and finds that while numbers are down, many of the ones performed were inappropriate. Bottom line, better education needs to be done to stress when and where it’s useful. Ingestions within 60 minutes of presentation of enough drug to have a serious toxic effect and where there’s no available antidote should prompt consideration for lavage in conjunction with a toxicologist when possible.
Recommended by: Anand Swaminathan
Toxicology Nelson CJ et al. Morbidity and mortality associated with medications used in the treatment of depression: an analysis of cases reported to US poison control centers 2010-2014. Am J Psychiatry 2017. PMID: 28135844
Use of TCAs and MAOIs for treatment of depression has largely given way to the more popular and safer SSRIs. Overdose of SSRIs are comparatively well tolerated and managed relatively easily with good supportive care. With the emergence of the newer antidepressants, particularly the DNRIs (bupropion) and SNRIs (venlafaxine, duloxitine), more serious and even fatal toxicities are not uncommon. Though causality cannot be inferred due to limitations in poison center data, this article highlights the increased attention and caution EM providers should give to overdoses of newer antidepressant medications.
Recommended by: Meghan Spyres
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Source: Life in the Fast Lane - Category: Emergency Medicine Authors: Nudrat Rashid Tags: Education General Surgery Infectious Disease Intensive Care Microbiology R&R in the FASTLANE Resuscitation Social Media Toxicology Toxicology and Toxinology critical care Emergency Medicine literature recommendations research a Source Type: blogs
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