Hypotones Kreislaufversagen und metabolische Azidose nach suizidaler Mischintoxikation mit Trimipramin und Quetiapin

Abstract

The case of a 44-year-old female patient is reported, who ingested trimipramine and quetiapine in a suicide attempt. Initially sinus tachycardia and hypotension were seen, which resulted in a hypotensive cardio-circulatory failure despite fluid therapy and administration of catecholamines. Because of the life-threatening situation and the fact that the ingestion was 2 h prior to admission, a rapid transport to the next hospital was preferred to treatment with active charcoal. Intoxication with tricyclic antidepressants are very common in Europe and have a mortality of up to 15% in severe cases. The specific therapy consists of airway management, hemodynamic stabilization and primary elimination of the poison. Secondary detoxication is less important. The administration of the antidote physostigmine is controversial but carbo medicinalis should be given orally or via a gastric tube.

Surface Modification of Silica Core−Shell Nanocapsules: Biomedical Implications

“…Among many nanoscience breakthroughs in recent years the potential of reducing toxic drug concentration in cases of overdose is particularly interesting to us. The importance of this approach comes from the fact that there are neither specific pharmacological antidotes nor immuno-toxicotherapeutic agents to overcome the effects of many drugs, at overdose concentrations, among them tricyclic antidepressants . Recently, two approaches to detoxification therapy using nanoparticles and nanoemulsions showed superior performance compared to their “macro” counterparts.…”

Fallbericht einer protrahierten Reanimation bei Suizidversuch mit Amitriptylin

“…Außerdem sollte durch die Gabe von Natriumbikarbonat die bei saurem pH auftretende Freisetzung von Amitriptylin aus der Plasmaeiweißbindung vermindert werden [2,3] [5]. Dass wir die Patientin nur moderat mit Bikarbonat puffern mussten, könnte durch die kontrollierte Beatmung er− klärt sein.…”