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?
Tag TCA
Pharm 101: Tricyclic Antidepressants
ACEM Primary Pharmacology of Tricyclic Antidepressants: the Pharmacokinetics; Pharmacodynamics; Clinical uses; Adverse effects
TCA toxicity
This is your one stop page for TCA overdose. Find out how to manage the acute overdose and the potential complications. We have also covered the basic TCA pharmacology and a tutorial about sodium channel blockade and the ECG, find out why the QRS will widen.
Seizures, Somnolence and a Scary ECG
An 18-year old male is brought to ED by ambulance following a generalised seizure at home. Has he taken TCA, can you save his life?
Tricyclic antidepressant toxicity
A 25 year-old male (70 kg) is brought in by ambulance 30 to 60 minutes after ingesting 70 x 50mg amitriptyline. He is tachycardic (HR 120) with an otherwise 'normal' ECG (QRS 95 ms) but is becoming drowsy. You are called to the resuscitation room to assess him.
ECG Case 056
Middle-aged patient presenting with drowsiness. Brief seizure in ED. BP unrecordable. Interpret the ECG.
ECG Case 055
Middle-aged patient presenting with drowsiness. BP 85/50. Pupils dilated. Interpret the ECG. TCA overdose, pseudo Brugada
ECG Case 004
A 20 year-old-male presents with seizures, BP 80/50, and a regular broad complex tachycardia. What is the diagnosis?
Tricyclic Overdose
A review of the ECG features seen in TCA overdose, which occur due to a combination of sodium channel blockade and antimuscarinic effects