Case Report
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Year 2021, Volume: 38 Issue: 1, 43 - 46, 26.01.2021

Hızır Akdemir Yavuz Cenik Mustafa Uras Neslihan Ünal

Abstract

References

  • Referans1 Agarwala, R., Ahmed, S.Z., Wiegand, T.J., 2014. Prolonged use of intravenous lipid emulsion in a severe tricyclic antidepressant overdose. J Med Toxicol. 10, 210-214.
  • Referans2 Aksakal, E., Ulus, T., Taş, H., Ocak, T., Sevimli, S., 2010. Prolonged QT interval after fexofenadine overdose in the presence of hypokalemia and hypocalcemia. Hong Kong J Emerg Med. 17, 75-78.
  • Referans3 American College of Medical Toxicology, 2011. ACMT Position Statement: interim guidance for the use of lipid resuscitation therapy. J Med Toxicol. 7, 81-82.
  • Referans4 Bateman, D.N., 2005. Tricyclic antidepressant poisoning: central nervous system effects and management. Toxicol Rev. 24, 181-186.
  • Referans5 Caksen, H., Akbayram, S., Odabaş, D., Ozbek, H., Erol, M., Akgün, C., Tuncer, O., Yilmaz, C., 2006. Acute amitriptyline intoxication: an analysis of 44 children. Hum Exp Toxicol. 25, 107-110.
  • Referans6 Chan, Y.C., Tse, M.L., Lau, F.L., 2010. Hong Kong Poison Information Centre: Annual Report 2008. Hong Kong J Emerg Med. 17, 395-405.
  • Referans7 Levine, M., Skolnik, A.B., Ruha, A.M., Bosak, A., Menke, N., Pizon, A.F., 2014. Complications following antidotal use of intravenous lipid emulsion therapy. J Med Toxicol. 10, 10-14.
  • Referans8 Odigwe, C.C,. Tariq, M., Kotecha, T., Mustafa, U., Senussi, N., Ikwu. I., Bhattarcharya, A., Ngene, J.I., Ojiako, K., Iroegbu, N., 2016. Tricyclic antidepressant overdose treated with adjunctive lipid rescue and plasmapheresis. Proc (Bayl Univ Med Cent). 29, 284-287.
  • Referans9 Ozcan, M.S., Weinberg, G., 2014. Intravenous lipid emulsion for the treatment of drug toxicity. J Intensive Care Med. 29, 59-70.
  • Referans10 Thanacoody, H.K., Thomas, S.H., 2005. Tricyclic antidepressant poisoning: cardiovascular toxicity. Toxicol Rev. 24, 205-214.

Successful treatment with intravenous lipid emulsion of severe tricyclic antidepressant intoxication

Year 2021, Volume: 38 Issue: 1, 43 - 46, 26.01.2021

Hızır Akdemir Yavuz Cenik Mustafa Uras Neslihan Ünal

Abstract

An overdose of amitriptyline has neurological and cardiovascular side effects (psychosis, lethargy, coma, hypotension, and dysrhythmia). A 19-year-old female patient was admitted to our emergency service after a suicide attempt by amitriptyline ingestion of unknown amount. Her follow-up demonstrated deteriorating consciousness and vital signs, she had a generalized tonic-clonic seizure, and her electrocardiogram (ECG) revealed QRS interval widening followed by a ventricular tachycardia (VT) attack. The patient was treated with intravenous (IV) diazepam (Diazem®) to control the epileptic seizure, IV lidocaine (Aritmal®) to stop the VT attack, and IV sodium bicarbonate due to QRS interval widening. The patient was given norepinephrine bitartrate (Steradine®) and dopamine hydrochloride (Dopamine®) due to low blood pressure. Intravenous lipid emulsion (ILE) therapy was started due to the uncontrolled rhythm and hypotension. Here, we present a case report of a comatose patient with dysrhythmia due to amitriptyline overdose who responds to ILE therapy.

Keywords

Tricyclic antidepressant Intoxication Dysrhythmia Coma Lipid emulsion Treatment

References

  • Referans1 Agarwala, R., Ahmed, S.Z., Wiegand, T.J., 2014. Prolonged use of intravenous lipid emulsion in a severe tricyclic antidepressant overdose. J Med Toxicol. 10, 210-214.
  • Referans2 Aksakal, E., Ulus, T., Taş, H., Ocak, T., Sevimli, S., 2010. Prolonged QT interval after fexofenadine overdose in the presence of hypokalemia and hypocalcemia. Hong Kong J Emerg Med. 17, 75-78.
  • Referans3 American College of Medical Toxicology, 2011. ACMT Position Statement: interim guidance for the use of lipid resuscitation therapy. J Med Toxicol. 7, 81-82.
  • Referans4 Bateman, D.N., 2005. Tricyclic antidepressant poisoning: central nervous system effects and management. Toxicol Rev. 24, 181-186.
  • Referans5 Caksen, H., Akbayram, S., Odabaş, D., Ozbek, H., Erol, M., Akgün, C., Tuncer, O., Yilmaz, C., 2006. Acute amitriptyline intoxication: an analysis of 44 children. Hum Exp Toxicol. 25, 107-110.
  • Referans6 Chan, Y.C., Tse, M.L., Lau, F.L., 2010. Hong Kong Poison Information Centre: Annual Report 2008. Hong Kong J Emerg Med. 17, 395-405.
  • Referans7 Levine, M., Skolnik, A.B., Ruha, A.M., Bosak, A., Menke, N., Pizon, A.F., 2014. Complications following antidotal use of intravenous lipid emulsion therapy. J Med Toxicol. 10, 10-14.
  • Referans8 Odigwe, C.C,. Tariq, M., Kotecha, T., Mustafa, U., Senussi, N., Ikwu. I., Bhattarcharya, A., Ngene, J.I., Ojiako, K., Iroegbu, N., 2016. Tricyclic antidepressant overdose treated with adjunctive lipid rescue and plasmapheresis. Proc (Bayl Univ Med Cent). 29, 284-287.
  • Referans9 Ozcan, M.S., Weinberg, G., 2014. Intravenous lipid emulsion for the treatment of drug toxicity. J Intensive Care Med. 29, 59-70.
  • Referans10 Thanacoody, H.K., Thomas, S.H., 2005. Tricyclic antidepressant poisoning: cardiovascular toxicity. Toxicol Rev. 24, 205-214.
There are 10 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Case Report
Authors

Hızır Akdemir

Yavuz Cenik This is me

Mustafa Uras

Neslihan Ünal This is me

Publication Date January 26, 2021
Submission Date May 18, 2020
Acceptance Date October 12, 2020
Published in Issue Year 2021 Volume: 38 Issue: 1

Cite

APA Akdemir, H., Cenik, Y., Uras, M., Ünal, N. (2021). Successful treatment with intravenous lipid emulsion of severe tricyclic antidepressant intoxication. Journal of Experimental and Clinical Medicine, 38(1), 43-46.
AMA Akdemir H, Cenik Y, Uras M, Ünal N. Successful treatment with intravenous lipid emulsion of severe tricyclic antidepressant intoxication. J. Exp. Clin. Med. January 2021;38(1):43-46.
Chicago Akdemir, Hızır, Yavuz Cenik, Mustafa Uras, and Neslihan Ünal. “Successful Treatment With Intravenous Lipid Emulsion of Severe Tricyclic Antidepressant Intoxication”. Journal of Experimental and Clinical Medicine 38, no. 1 (January 2021): 43-46.
EndNote Akdemir H, Cenik Y, Uras M, Ünal N (January 1, 2021) Successful treatment with intravenous lipid emulsion of severe tricyclic antidepressant intoxication. Journal of Experimental and Clinical Medicine 38 1 43–46.
IEEE H. Akdemir, Y. Cenik, M. Uras, and N. Ünal, “Successful treatment with intravenous lipid emulsion of severe tricyclic antidepressant intoxication”, J. Exp. Clin. Med., vol. 38, no. 1, pp. 43–46, 2021.
ISNAD Akdemir, Hızır et al. “Successful Treatment With Intravenous Lipid Emulsion of Severe Tricyclic Antidepressant Intoxication”. Journal of Experimental and Clinical Medicine 38/1 (January 2021), 43-46.
JAMA Akdemir H, Cenik Y, Uras M, Ünal N. Successful treatment with intravenous lipid emulsion of severe tricyclic antidepressant intoxication. J. Exp. Clin. Med. 2021;38:43–46.
MLA Akdemir, Hızır et al. “Successful Treatment With Intravenous Lipid Emulsion of Severe Tricyclic Antidepressant Intoxication”. Journal of Experimental and Clinical Medicine, vol. 38, no. 1, 2021, pp. 43-46.
Vancouver Akdemir H, Cenik Y, Uras M, Ünal N. Successful treatment with intravenous lipid emulsion of severe tricyclic antidepressant intoxication. J. Exp. Clin. Med. 2021;38(1):43-6.
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