Tricyclic antidepressant poisoning. How to assess, treat and observe after this dangerous overdose.

What do you do when a drug affects almost every receptor you can remember? Sodium channel blockade, alpha blockade, anticholinergic effects, and antihistamines. Like many scenarios in toxicology, one of the most important things you can do is avoid acidaemia. This and excellent supportive care are the things most likely to save a patient's life.

1) Give activated charcoal
2) Avoid apnoea due to seizures or muscle paralysis (e.g. when intubating)
3) Use bicarbonate/hyperventilation to increase pH
4) Give vasopressors
5) Anticipate deterioration and intubate early if appropriate

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Please note, this video is not medical advice

References:

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