A 42-year-old woman is brought to the emergency department after being found collapsed at home. She has an empty bottle of tricyclic antidepressant (a...

Question

A 42-year-old woman is brought to the emergency department after being found collapsed at home. She has an empty bottle of tricyclic antidepressant (amitriptyline) beside her. ECG shows a QRS duration of 160 ms and a heart rate of 55 bpm. BP is 75/45 mmHg. She is obtunded (GCS 8). What is the most important immediate pharmacological intervention?

Accepted Answer

IV sodium bicarbonate 8.4% - 50 mL bolus, repeated as needed to narrow QRS

Answer

IV lipid emulsion (Intralipid) 20% - 1.5 mL/kg bolus

Answer

IV glucagon 5 mg bolus

Answer

IV flumazenil 0.2 mg

Answer

IV N-acetylcysteine loading dose

uk-fficm MCQ (SBA): Tricyclic Antidepressant Overdose