Mortal Seyreden Bir Amitriptilin İntoksikasyonu Olgusu

Öz

Özet

Trisiklik antidepresanların (TCA) aşırı alımı, ciddi ilaç zehirlenmelerinin en sık sebeplerinden biridir. Görece düşük (10 mg / kg) bir dozda amitriptilinin intihar etmek amacıyla içimi sonrası TCA zehirlenmesine bağlı çok şiddetli nörolojik ve kardiyovasküler belirtiler gösteren 20 yaşında bir kadın hastayı sunuyoruz. Gastrik lavaj, aktif kömür, sistemik alkalinizasyon (pH 7.50 olacak şekilde), destek tedavi ve plazma değişim tedavileri hasta için yeterli olmadı. Hastanın derin koma durumu ve şok tablosu devam etti ve herhangi bir önlem hastayı hayatta tutmaya yetmedi. Bu vaka, TCA zehirlenmesinin önemini ve bu zehirlenmenin düşük dozlarda dahi ölümcül olabileceğini vurgulamaktadır.

Anahtar Kelimeler

• Amitriptilin, aşırı dozda ilaç alımı, zehirlenme, intihar

A Case Report of Mortal Intoxication of Amitriptyline

Abstract

Tricyclic antidepressant (TCA) overdose is one of the most common causes of serious drug poisonings. We here report a case with neurologic and cardiovascular manifestations of TCA intoxication following self-poisoning with amitriptyline in a relatively low dose of 10 mg/kg, in a 20-year-old female. Management with gastric lavage, activated charcoal, systemic alkalinization (pH 7.50), supportive care and plasma exchange therapy were not enough for the patient. Deep coma and shock persisted and no measures were enough to keep the patient alive. This case focuses on the importance of TCA intoxication and emphasizes that it can be fatal even at relatively low doses.

Keywords

• Amitriptyline, drug overdose, intoxication,suicide

Kaynakça

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13. Yazışma Adresi / Correspondence Dr. Sertaç Güler Ankara Eğitim ve Araştırma Hastanesi, Acil Tıp Kliniği, Ankara / TÜRKİYE Tel: [phone] e-posta: [e-mail] Geliş Tarihi: 18.03.2014 Kabul Tarihi: 27.05.2014 Yoldaş ve arkadaşları 14