Beneficial effect of norepinephrine in the treatment of circulatory shock caused by tricyclic antidepressant overdose

Teba, Luis; Schiebel, Franklin; Dedhia, Harakh V.; Lazzell, V. A.

doi:10.1016/0735-6757(88)90092-7

Cited by 44 publications

(15 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…In other cases, bicarbonate was given either without improvement or with an unreported response (3,43,82,92,154,173,174,197,209,212,213,(215)(216)(217)(218)(219)(220)(221)(222)(223). There were also cases in which bicarbonate might have resulted in or contributed to adverse effects (e.g., pulmonary edema or excessive alkalemia) (75,82,202).…”

Section: Sodium Bicarbonatementioning

confidence: 99%

Tricyclic antidepressant poisoning: an evidence-based consensus guideline for out-of-hospital management

Woolf

Erdman

Nelson

et al. 2007

Clinical Toxicology

130

View full text Add to dashboard Cite

American Association of Poison Control Centers, Washington, District of Columbia, USAA review of U.S. poison center data for 2004 showed over 12,000 exposures to tricyclic antidepressants (TCAs). A guideline that determines the conditions for emergency department referral and prehospital care could potentially optimize patient outcome, avoid unnecessary emergency department visits, reduce healthcare costs, and reduce life disruption for patients and caregivers. An evidencebased expert consensus process was used to create the guideline. Relevant articles were abstracted by a trained physician researcher. The first draft of the guideline was created by the lead author. The entire panel discussed and refined the guideline before distribution to secondary reviewers for comment. The panel then made changes based on the secondary review comments. The objective of this guideline is to assist poison center personnel in the appropriate prehospital triage and management of patients with suspected ingestions of TCAs by 1) describing the manner in which an ingestion of a TCA might be managed, 2) identifying the key decision elements in managing cases of TCA ingestion, 3) providing clear and practical recommendations that reflect the current state of knowledge, and 4) identifying needs for research. This guideline applies to ingestion of TCAs alone. Co-ingestion of additional substances could require different referral and management recommendations depending on their combined toxicities. This guideline is based on the assessment of current scientific and clinical information. The panel recognizes that specific patient care decisions may be at variance with this guideline and are the prerogative of the patient and the health professionals providing care, considering all the circumstances involved. This guideline does not substitute for clinical judgment. Recommendations are in chronological order of likely clinical use. The grade of recommendation is in parentheses. 1) Patients with suspected self-harm or who are the victims of malicious administration of a TCA should be referred to an emergency department immediately (Grade D). 2) Patients with acute TCA ingestions who are less than 6 years of age and other patients without evidence of self-harm should have further evaluation including standard history taking and determination of the presence of co-ingestants (especially other psychopharmaceutical agents) and underlying exacerbating conditions, such as convulsions or cardiac arrhythmias. Ingestion of a TCA in combination with other drugs might warrant referral to an emergency department. The ingestion of a TCA by a patient with significant underlying cardiovascular or neurological disease should cause referral to an emergency department at a lower dose than for other individuals. Because of the potential severity of TCA poisoning, transportation by EMS, with close monitoring of clinical status and vital signs en route, should be considered (Grade D). 3) Patients who are symptomatic (e.g., weak, drowsy, dizzy, tremulous, pal...

show abstract

Section: Sodium Bicarbonatementioning

confidence: 99%

Tricyclic antidepressant poisoning: an evidence-based consensus guideline for out-of-hospital management

Woolf

Erdman

Nelson

et al. 2007

Clinical Toxicology

130

View full text Add to dashboard Cite

show abstract

“…If hypotension persists, epinephrine and norepinephrine are more effective than dopamine in raising blood pressure. 385,386 • Consider ECMO if high-dose vasopressors do not maintain blood pressure. 387,388 Calcium Channel Blockers…”

Section: Treatmentmentioning

confidence: 99%

Part 14: Pediatric Advanced Life Support

Kleinman¹,

Chameides²,

Schexnayder³

et al. 2010

Circulation

913

304

View full text Add to dashboard Cite

“…Case reports and retrospective case series imply that TCA-related hypotension may be more responsive to norepinephrine than dopamine [95,96]. In a dog model, TCA-induced hypotension was equally responsive to dopamine and norepinephrine.…”

Section: Vasoactive Agentsmentioning

confidence: 97%

Therapeutic Approach to the Critically Poisoned Patient

Schwarz¹

2016

Critical Care Toxicology

View full text Add to dashboard Cite

Beneficial effect of norepinephrine in the treatment of circulatory shock caused by tricyclic antidepressant overdose

Cited by 44 publications

References 9 publications

Tricyclic antidepressant poisoning: an evidence-based consensus guideline for out-of-hospital management

Tricyclic antidepressant poisoning: an evidence-based consensus guideline for out-of-hospital management

Part 14: Pediatric Advanced Life Support

Therapeutic Approach to the Critically Poisoned Patient

Contact Info

Product

Resources

About