Tricyclic Antidepressant Overdose Flashcards
What is tricylic antidepressant overdose?
It is defined as excessive ingestion of tricyclic antidepressants
Which two tricylic antidepressants are most dangerous to overdose on?
Amitriptyline
Dosulepin
What are four risk factors of tricylic antidepressant overdose?
Previous Suicide Attempt
Previous Self-Harm
Psychiatric History
Cognitive impairment
Following tricylic antidepressant overdose, when do clinical features tend to present?
> 6 hours
What are the clinical features of tricylic antidepressant overdose related to?
Anticholinergic toxicity
What are the eleven clinical features of tricylic antidepressant overdose?
Dry Mouth/Skin
Blurred Vision
Pupil Dilatation
Urinary Retention
Seizures
Syncope
Irritability
Confusion
Tachycardia
Arrythmias
Hypotension
What are the three investigations used to diagnose tricylic antidepressant overdoses?
Blood Tests
Arterial Blood Gas (ABG)
ECG Scan
What two blood test results indicate tricylic antidepressant overdoses?
Decreased Potassium Levels
Decreased Magnesium Levels
What ABG result indicates tricylic antidepressant overdose?
Metabolic acidosis
What are the three features of tricylic antidepressant overdose on ECG scans?
Sinus Tachycardia
Widened QRS Complexes
Prolonged QTc Interval
What dose a QRS complex > 100ms indicate in tricylic antidepressant overdose?
Seizure Risk
What dose a QRS complex > 160ms indicate in tricylic antidepressant overdose?
Ventricular Arrythmia Risk
What are the two pharmacological management options of tricylic antidepressant overdose?
Activated Charcoal
IV Sodium Bicarbonate
When is activated charcoal used to treat tricylic antidepressant overdose?
When individuals present within one hour of overdose
How is activated charcoal used to manage tricylic antidepressant overdose?
It is used to reduce absorption of the drug