Tricyclic antidepressant (TCA) overdose
- Sodium bicarbonate is the core antidotal therapy
- Treat QRS widening, ventricular dysrhythmia + hypotension
- Benzodiazepines for seizures
- Avoid class IA/IC antiarrhythmics
- Continuous ECG + aggressive airway support
- Severe refractory cardiotoxicity may need lipid/ECMO
Use at a glance
- Sodium bicarbonate is the core antidotal therapy
Treatment options
- Treat QRS widening, ventricular dysrhythmia + hypotension
- Benzodiazepines for seizures
Safety / pitfalls
- Avoid class IA/IC antiarrhythmics
Escalation / refractory disease
- Continuous ECG + aggressive airway support
- Severe refractory cardiotoxicity may need lipid/ECMO
Self-check
- What is the core antidotal therapy for TCA overdose?
Sodium bicarbonate. - Which antiarrhythmics are avoided in TCA overdose?
Class IA/IC antiarrhythmics.
Drugs used for this (1)
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