Overdose

Question 1

What are the common Tricyclic Antidepressants seen in overdose?

Answer 1

Amitriptyline
Nortriptyline
Dothiepin

NB: TCAs may also be prescribed to treat conditions other than depression, such as chronic pain.

Question 2

What are the common Opioids seen in overdose?

Answer 2

Heroin
Morphine
Codeine
Endone
MS Contin

Question 3

What are the common Sedatives seen in overdose?

Answer 3

GHB
Alcohol
Benzodiazepines

Question 4

What are the common Psychostimulants seen in overdose?

Answer 4

Cocaine
Amphetamines
MDMA
Ecstacy
PCP

Question 5

What are the signs and symptoms of mild to moderate TCA toxicity?

Answer 5

• drowsiness, confusion
• slurred speech / ataxia (lack of muscle coordination affecting eye movement, swallowing, speech and other voluntary movements)
• dry mucous membranes
• tachycardia
• mild hypertension
• respiratory depression
• hyperreflexia

Question 6

What are the signs and symptoms of severe TCA toxicity?

Answer 6

• coma
• seizures (risk is increased if QRS > 0.10 seconds)
• conduction delays (prolonged PR, QRS and QT intervals)
• ventricular arrythmias (SVT, VT, PVCs) (risk is increased if QRS > 0.16 seconds)
• hypotension
• respiratory depression / hypoventilation

This in turn can lead to aspiration, APO, hyperthermia and rhabdomyolysis. These patients require MICA activation.