Antagonism of imipramine poisoning by anticonvulsants in the rat

Beaubien, A R; Carpenter, Dustin; Mathieu, L.; MacConaill, M. A.; Hrdina, Pavel D.

doi:10.1016/0041-008x(76)90154-x

Cited by 19 publications

(4 citation statements)

References 20 publications

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“…15 Seizures are generally short lived and are treated using benzodiazepines. 171 Patients who have seizures should receive sodium bicarbonate (1-2 ml/kg bolus of 8.4% IV solution, repeated every 15-30 minutes to maintain pH 7.5-7.55) to limit further acidosis (which increases the risk of arrhythmias) and the transit of TCA into the CNS. 166 Resistant seizures should be treated aggressively with general anaesthetic sedation and supportive care.…”

Section: Tricyclic Antidepressantsmentioning

confidence: 99%

Acute poisoning: understanding 90% of cases in a nutshell

Greene¹,

Dargan²,

Jones³

2005

Postgraduate Medical Journal

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The acutely poisoned patient remains a common problem facing doctors working in acute medicine in the United Kingdom and worldwide. This review examines the initial management of the acutely poisoned patient. Aspects of general management are reviewed including immediate interventions, investigations, gastrointestinal decontamination techniques, use of antidotes, methods to increase poison elimination, and psychological assessment. More common and serious poisonings caused by paracetamol, salicylates, opioids, tricyclic antidepressants, selective serotonin reuptake inhibitors, benzodiazepines, non-steroidal anti-inflammatory drugs, and cocaine are discussed in detail. Specific aspects of common paediatric poisonings are reviewed.

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Section: Tricyclic Antidepressantsmentioning

confidence: 99%

Acute poisoning: understanding 90% of cases in a nutshell

Greene¹,

Dargan²,

Jones³

2005

Postgraduate Medical Journal

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“…9 Although some recommend the use of phenytoin its eYcacy has never been proven 67 and in a rat model was found to be of no benefit. 84 Patients with decreased conscious level and respiratory depression may require intubation.…”

Section: Cns Complicationsmentioning

confidence: 99%

Tricyclic antidepressant overdose: a review

Kerr

McGuffie²,

Wilkie³

2001

Emergency Medicine Journal

243

168

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“…Coincident endotracheal intubation may be required. Phenytoin and non-barbiturate anticonvulsants are typically ineffective or harmful in toxin-induced seizures [18,19]. Altered mental status should also prompt parenteral administration of 100 mg thiamine hydrochloride.…”

Section: General Approach To the Poisoned Patientmentioning

confidence: 99%

Drugs and pharmaceuticals: management of intoxication and antidotes

Smith

2010

Experientia Supplementum

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The treatment of patients poisoned with drugs and pharmaceuticals can be quite challenging. Diverse exposure circumstances, varied clinical presentations, unique patientspecific factors, and inconsistent diagnostic and therapeutic infrastructure support, coupled with relatively few definitive antidotes, may complicate evaluation and management. The historical approach to poisoned patients (patient arousal, toxin elimination, and toxin identification) has given way to rigorous attention to the fundamental aspects of basic life supportairway management, oxygenation and ventilation, circulatory competence, thermoregulation, and substrate availability. Selected patients may benefit from methods to alter toxin pharmacokinetics to minimize systemic, target organ, or tissue compartment exposure (either by decreasing absorption or increasing elimination). These may include syrup of ipecac, orogastric lavage, activated single-or multi-dose charcoal, whole bowel irrigation, endoscopy and surgery, urinary alkalinization, saline diuresis, or extracorporeal methods (hemodialysis, charcoal hemoperfusion, continuous venovenous hemofiltration, and exchange transfusion). Pharmaceutical adjuncts and antidotes may be useful in toxicant-induced hyperthermias. In the context of analgesic, anti-inflammatory, anticholinergic, anticonvulsant, antihyperglycemic, antimicrobial, antineoplastic, cardiovascular, opioid, or sedative-hypnotic agents overdose, N-acetylcysteine, physostigmine, L-carnitine, dextrose, octreotide, pyridoxine, dexrazoxane, leucovorin, glucarpidase, atropine, calcium, digoxin-specific antibody fragments, glucagon, high-dose insulin euglycemia therapy, lipid emulsion, magnesium, sodium bicarbonate, naloxone, and flumazenil are specifically reviewed. In summary, patients generally benefit from aggressive support of vital functions, careful history and physical examination, specific laboratory analyses, a thoughtful consideration of the risks and benefits of decontamination and enhanced elimination, and the use of specific antidotes where warranted. Data supporting antidotes effectiveness vary considerably. Clinicians are encouraged to utilize consultation with regional poison centers or those with toxicology training to assist with diagnosis, management, and administration of antidotes, particularly in unfamiliar cases.

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Antagonism of imipramine poisoning by anticonvulsants in the rat

Cited by 19 publications

References 20 publications

Acute poisoning: understanding 90% of cases in a nutshell

Acute poisoning: understanding 90% of cases in a nutshell

Tricyclic antidepressant overdose: a review

Drugs and pharmaceuticals: management of intoxication and antidotes

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