In patients with dysrhythmias following tricyclic overdose patients treatment should include alkalinisation to a pH of 7.55

Report By: Kevin Mackway-Jones - Consultant
Search checked by Martin Thomas - Research Fellow
Institution: Manchester Royal Infirmary
Date Submitted: 1st March 2000
Date Completed: 30th June 2000
Last Modified: 11th April 2001
Status: Green (complete)

Three Part Question

In a [young adult with dysrhythmias following tricyclic antidepressant overdose] is [treatment with bicarbonate better than no active treatment] at [normalising cardiovascular function]?

Clinical Scenario

A 27 year old woman presents with a history of having taken 30 tricyclic antidepressant tablets 3 hours before admission. ECG monitoring shows frequent dysrhythmias. You wonder whether giving sodium bicarbonate intravenously is worthwhile.

Search Strategy

Medline 1966-12/98 using the OVID interface.
({[exp bicarbonates OR bicarbonate$.mp] AND [antidepressive agents, tricyclic OR exp amitriptyline OR exp imipramine OR exp desipramine OR exp fluoxetine OR tricyclic$.mp]} LIMIT to human AND english language)