BOF: 2.58
A 36-year-old female has been admitted as an emergency
having taken an overdose of dosulepin.
She is drowsy and has dilated pupils. Whilst you are
examining her you notice that the ECG monitor show supraventricular
tachycardia.
Which one of the following would you administer to this
patient?
a)
Adenosine
b)
Verapamil
c)
Lidocaine
d)
Amiodarone
e)
Sodium bicarbonate
Answer:
e)
In poisoning with tricyclic antidepressants, the onset of
supraventricular or ventricular tachycardia is an indication for treatment
with sodium bicarbonate 50 mmol (50 mL of 8.4%) over 20 minutes.
This should be given even if there is no acidosis.
