Cardiotoxic Side Effects Associated with Tricyclic Antidepressant Overdose

1992 ◽  
Vol 3 (1) ◽  
pp. 226-232 ◽  
Author(s):  
Nancy A. Keis
Keyword(s):  
Patient Outcomes ◽  
Tricyclic Antidepressants ◽  
Fatal Outcome ◽  
Severe Depression ◽  
Tricyclic Antidepressant ◽  
Nursing Interventions ◽  
Cardiac Symptoms ◽  
Tricyclic Antidepressant Overdose ◽  
Electrocardiographic Changes ◽  
Effective Medication

Tricyclic antidepressants (TCAs) arc a popular, effective medication prescribed for patients with depression. The patient with severe depression may exhibit suicidal tendencies; thus, overdose of a prescribed TCA may occur, resulting in a potentially fatal outcome. The cardiotoxic effect of TCA overdose is the most pronounced complication. Multiple rhythm disturbances may occur in the presence of a TCA overdose. The greatest number of adverse cardiac symptoms and electrocardiographic changes are likely to occur within the first 24 hours after overdose. Nursing care of the patient with a TCA overdose is based upon ongoing patient assessment, identification of problems and potential problems, establishment of expected patient outcomes, and specific nursing interventions

Anticholinergic Toxicity

2016 ◽  
Author(s):  
Jeffrey T Lai ◽  
Kavita M Babu
Keyword(s):  
Prescription Medication ◽  
Tricyclic Antidepressant ◽  
Over The Counter ◽  
Anticholinergic Activity ◽  
Anticholinergic Medications ◽  
Tricyclic Antidepressant Overdose ◽  
Wide Range ◽  
Definitive Therapy ◽  
Electrocardiographic Changes ◽  
Seasonal Allergies

Anticholinergic compounds oppose the action of the endogenous neurotransmitter acetylcholine at its target receptors and are found in over-the-counter and prescription medication, natural products, and plants. Anticholinergic medications, such as atropine and scopolamine, are used for the treatment of a wide range of conditions, including bradycardia, motion sickness, and insomnia. Antihistaminergic medications, such as diphenhydramine, also possess anticholinergic activity and are used in the treatment of seasonal allergies, common cold symptoms, and allergic reactions. Other medications, such as antidepressants (especially the older tricyclic class), antipsychotics, muscle relaxants, and anticonvulsants, can act as anticholinergic agents or produce anticholinergic side effects. Toxicity can result from therapeutic misadventure, intentional overdose, recreational use, and pediatric exposures. This review covers the principles of toxicity, immediate stabilization, diagnosis and definitive therapy, and disposition and outcomes. Figures show the anticholinergic toxidrome, look-alike structures, and electrocardiographic changes in tricyclic antidepressant overdose. Tables list medications with anticholinergic activity and selected botanicals that cause anticholinergic toxicity. Key words: anticholinergic overdose, anticholinergic toxicity, anticholinergic toxidrome, physostigmine, tricyclic antidepressant toxicity This review contains 3 highly rendered figures, 2 tables, and 49 references.

Anticholinergic Toxicity

2016 ◽  
Author(s):  
Jeffrey T Lai ◽  
Kavita M Babu
Keyword(s):  
Prescription Medication ◽  
Tricyclic Antidepressant ◽  
Over The Counter ◽  
Anticholinergic Activity ◽  
Anticholinergic Medications ◽  
Tricyclic Antidepressant Overdose ◽  
Wide Range ◽  
Definitive Therapy ◽  
Electrocardiographic Changes ◽  
Seasonal Allergies

Anticholinergic compounds oppose the action of the endogenous neurotransmitter acetylcholine at its target receptors and are found in over-the-counter and prescription medication, natural products, and plants. Anticholinergic medications, such as atropine and scopolamine, are used for the treatment of a wide range of conditions, including bradycardia, motion sickness, and insomnia. Antihistaminergic medications, such as diphenhydramine, also possess anticholinergic activity and are used in the treatment of seasonal allergies, common cold symptoms, and allergic reactions. Other medications, such as antidepressants (especially the older tricyclic class), antipsychotics, muscle relaxants, and anticonvulsants, can act as anticholinergic agents or produce anticholinergic side effects. Toxicity can result from therapeutic misadventure, intentional overdose, recreational use, and pediatric exposures. This review covers the principles of toxicity, immediate stabilization, diagnosis and definitive therapy, and disposition and outcomes. Figures show the anticholinergic toxidrome, look-alike structures, and electrocardiographic changes in tricyclic antidepressant overdose. Tables list medications with anticholinergic activity and selected botanicals that cause anticholinergic toxicity. Key words: anticholinergic overdose, anticholinergic toxicity, anticholinergic toxidrome, physostigmine, tricyclic antidepressant toxicity This review contains 3 highly rendered figures, 2 tables, and 49 references.

Dibenzepin Overdose Causing Pulmonary Edema

1996 ◽  
Vol 30 (7-8) ◽  
pp. 789-790 ◽  
Author(s):  
Eytan Wirtheim ◽  
Yuval Bloch
Keyword(s):  
Pulmonary Edema ◽  
Tricyclic Antidepressants ◽  
Distress Syndrome ◽  
Medical Condition ◽  
Left Ventricular ◽  
Tricyclic Antidepressant ◽  
Contributing Factors ◽  
Case Summary ◽  
Tricyclic Antidepressant Overdose ◽  
Cardiopulmonary Complications

OBJECTIVE: To report a case of pulmonary edema due to dibenzepin overdose. CASE SUMMARY: A 39-year-old woman was hospitalized 24 hours after she ingested eight tablets of dibenzepin hydrochloride delayed-release 240 mg/tablet (∼35 mg/kg body weight). On admission the patient was confused, and physical examination revealed sinus tachycardia (HR 130 beats/min). Forty-five hours after ingestion of the dibenzepin she developed pulmonary edema and was treated with furosemide, morphine, and mechanical ventilation through an endotracheal tube for 48 hours. Repeated echocardiography revealed left ventricular dysfunction that resolved as the medical condition of the patient improved. Appropriate studies excluded pneumonia, pneumonitis, adult respiratory distress syndrome, myocardial infarction, and pulmonary emboli as contributing factors to this patient's condition. DISCUSSION: Tricyclic antidepressant overdose is known to cause cardiopulmonary complications, including pulmonary edema. To the best of our knowledge, this is the first reported case of pulmonary edema as a result of dibenzepin overdose. The most probable mechanism for this complication is depression of left ventricular function. CONCLUSIONS: As with other tricyclic antidepressants, dibenzepin toxicity may cause pulmonary edema. Close patient monitoring is essential for at least 48-72 hours after the overdose.

Swiss Prison Suicides Between 2000 and 2010

Crisis ◽  
2015 ◽  
Vol 36 (2) ◽  
pp. 110-116 ◽  
Author(s):  
Saskia Gauthier ◽  
Thomas Reisch ◽  
Christine Bartsch
Keyword(s):  
Tricyclic Antidepressants ◽  
Tricyclic Antidepressant ◽  
Legal Medicine ◽  
Prevention Strategies ◽  
International Context ◽  
Retrospective Data Analysis ◽  
Tricyclic Antidepressant Overdose ◽  
New Findings ◽  
Assessment Sheet ◽  
Self Immolation

Background: Suicide is the leading cause of death in Swiss prisons. The Federal Statistics Office provides numbers but no further details. Previous studies worldwide have focused on identifying suicide risk factors in prisoners, but very few have looked at the methods used in relation to prevention strategies. Aims: To obtain details of Swiss prison suicides, determine new findings in an international context, and establish prevention strategies based on the information acquired. Method: Retrospective data analysis of prison suicides extracted from the database of all suicides investigated by Swiss institutes of legal medicine between 2000 and 2010, using a standardized assessment sheet. Results: Out of 4,885 suicides investigated in the institutes of legal medicine in Switzerland, we identified 50 (1.02%) inmate suicides. Most were unmarried Swiss men, with a median age of 32 years. The two most common methods used were hanging and tricyclic antidepressant overdose. Two died due to self-immolation. Conclusion: Swiss prison suicides do not differ from those in other countries regarding sociodemographic details and the most common method of hanging. Anchoring devices, even low ones, should be avoided to prevent hanging and medication intake should be monitored. As prisoners use tricyclic antidepressants to die by suicide, we recommend the general monitoring of intake.

Treatment of severe tricyclic antidepressant overdose with extracorporeal sorbent detoxification

2002 ◽  
Vol 9 (1) ◽  
pp. 31-41 ◽  
Author(s):  
Stephen R. Ash ◽  
Howard Levy ◽  
Mohammed Akmal ◽  
Rita A. Mankus ◽  
James M. Sutton ◽  
...  
Keyword(s):  
Tricyclic Antidepressant ◽  
Antidepressant Overdose ◽  
Tricyclic Antidepressant Overdose
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