TCA overdose – beyond bicarbonate
A 38 yr old male presents to your ED, 2 hours after ingesting an unknown quantity of amitriptyline (TCA) with a GCS of 13, HR 130, BP96/50. How do you proceed?
AGENTS local anesthetic agents tricyclic antidepressants carbamazepine (in very high doses) dextropropoxyphene antiarrhythmics e.g. flecainide, quinine propanolol thioridizine phenothiazines (not usually clinically significant) amantidine NB. phenytoin and sodium valproate do not usually present with features of sodium channel blockade in…