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?
A young male is unconscious and on his way to your hospital. Bystanders confirm he has been depressed and taken an overdose. The paramedics are worried about his ECG..."it looks weird and his QRS is very wide". The following tox tute will guide you through managing this patient.
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.
Tricyclic Antidepressants (TCA) are weak bases (pKa 8.5) that can cause life-threatening sodium channel toxicity