Sodium Bicarbonate and Tricyclic-Antidepressant Poisoning

Gaultier, M

doi:10.1016/s0140-6736(76)91200-9

Cited by 11 publications

(2 citation statements)

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“…Reproduction of QRS widening and increases in heart rate were produced by adding CO2 to the inspired air until normocapnia was achieved (7). Metabolic alkalosis has also been reported to reverse cardiac arrhythmias and to reduce mortality (8,17), although an effect of sodium was also claimed. Alkalosis also reverses the decrease in extrasystolic threshold seen in experimental TCA poisoning (18), and increases elimination of TCA from tissues because of increased protein-binding (19).…”

Section: Discussionmentioning

confidence: 99%

Acute Self‐Poisoning with Tricyclic Antidepressants in 295 Consecutive Patients Treated in an ICU

Strøm

Madsen

Nielsen

et al. 1984

Acta Anaesthesiol Scand

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Clinical findings on admission to hospital and outcome in 295 consecutive patients with severe tricyclic antidepressant self-poisoning treated in an ICU are presented. Cerebral depression was observed in 92%, convulsions in 23% and respiratory failure was present in 72%. Cardiovascular function was impaired in 44% and an abnormal ECG was found in 57%. Cardiac arrest was treated in 14 patients (6%) of whom seven were resuscitated. The mortality rate was 2%. All patients were artificially ventilated. A beneficial effect of respiratory alkalosis on cardiac arrhythmias is supported.

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Section: Discussionmentioning

confidence: 99%

Acute Self‐Poisoning with Tricyclic Antidepressants in 295 Consecutive Patients Treated in an ICU

Strøm

Madsen

Nielsen

et al. 1984

Acta Anaesthesiol Scand

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“…However, Bailey hypothesized in his case reports of using molar sodium lactate for quinidine toxicity that the increase in sodium concentration was important for its effect [14]. The controversy of whether or not the effectiveness of sodium bicarbonate was due to sodium or alkalemia would continue to be debated in the following decades [16][17][18].…”

Section: History Of Sodium Bicarbonate Therapymentioning

confidence: 99%

A Literature Review of the Use of Sodium Bicarbonate for the Treatment of QRS Widening

Bruccoleri

Burns

2015

J. Med. Toxicol.

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Sodium bicarbonate is a well-known antidote for tricyclic antidepressant (TCA) poisoning. It has been used for over half a century to treat toxin-induced sodium channel blockade as evidenced by QRS widening on the electrocardiogram (ECG). The purpose of this review is to describe the literature regarding electrophysiological mechanisms and clinical use of this antidote after poisoning by tricyclic antidepressants and other agents. This article will also address the literature supporting an increased serum sodium concentration, alkalemia, or the combination of both as the responsible mechanism(s) for sodium bicarbonate's antidotal properties. While sodium bicarbonate has been used as a treatment for cardiac sodium channel blockade for multiple other agents including citalopram, cocaine, flecainide, diphenhydramine, propoxyphene, and lamotrigine, it has uncertain efficacy with bupropion, propranolol, and taxine-containing plants.

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Sodium Channel-Blocking Antidysrhythmics

Smith¹

2017

Critical Care Toxicology

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Sodium Bicarbonate and Tricyclic-Antidepressant Poisoning

Cited by 11 publications

References 1 publication

Acute Self‐Poisoning with Tricyclic Antidepressants in 295 Consecutive Patients Treated in an ICU

Acute Self‐Poisoning with Tricyclic Antidepressants in 295 Consecutive Patients Treated in an ICU

A Literature Review of the Use of Sodium Bicarbonate for the Treatment of QRS Widening

Sodium Channel-Blocking Antidysrhythmics

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