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.
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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