HI, DOCTORS... PLEASE HELP ME IN IMPROVING MY BLOG... ITS ONLY FOR DOCS AND THOSE WHO ARE INTERESTED IN MEDICINE. TODAY, LET'S HAVE A 'PGMEE' TYPE LOOK OVER AMITRYPTYLINE
Amitryptyline
§ Tricyclic antidepressant
§ Anticholinergic properties
Management of amytryptiline poisoning
§ Airway, Breathing
§ i.v. fluids
§ if refractory to i.v. fluids------- vasopressors with alpha-agonist effect (e.g. neo syphrine , norepinephrine)
§ GIT lavage/ decontamination after stabilizing patient
§ Cardiovascular toxicity------ serum alkalinasation with i.v. NaHCO3(mainstay of therapy).Prolonged QRS ≥ 100 msec m.c. indication for serum alkalization in amytryptiline toxicity
§ DIAZEPAM/ Benzodiazepine--- TOC for prolonged or recurrent seizures (seizures in TCA toxicity are usually self-limited)
§ ATROPINE is CANNOT be used as antidote
§ Use of hypertonic saline – controversial
§ Hemodialysis NO ROLE
§ Hemoperfusion NO ROLE
§ Physostigmine NOT USED D/T RISK OF INDUCING SIEZURES
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