Case Number 16 Amitriptyline Overdose

Thompson, Gregory A.

doi:10.1177/106002807300701003

Cited by 6 publications

(1 citation statement)

References 29 publications

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“…ECG changes include tachycardia, arrhythmias, widening of the PQ and QRS complex, ST and T wave abnormalities. It has also been shown that antidepressant drugs aggravate cardiac disease especially in elderly people suffering from hypertension and atherosclerosis (Muller, Goodman & Bellet, 1961;Kristiansen, 1961;Skou, 1962;Thompson, 1973).…”

Section: Introductionmentioning

confidence: 99%

Plasma Nortriptyline and Cardiac Responses in Young and Old Rats

Bonaccorsi

Franco

Garattini

et al. 1977

British J Pharmacology

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The relationship between plasma concentrations and cardiac effects of nortriptyline was studied in anaesthetized young and old rats. Nortriptyline was administered by two consecutive intravenous infusions which resulted in a peak plasma concentration followed by steady state values. Increasing infusion rates were followed by proportional increases in the drug plasma concentrations ranging from 0.15 to 6.0 μg/ml. In young rats, nortriptyline induced an increase in the heart rate, a right rotation of the electrical axis and a prolongation of the PQ interval. Heart rate changes were not correlated with nortriptyline plasma concentrations, while significant correlations were found for the other two parameters. Plasma concentrations inducing 20% increase of the PQ interval and 40 degrees rotation of the electrical axis were 1.65 and 1.69 μg/ml respectively. Arrhythmias occurred at concentrations higher than 5.2 μg/ml. Nortriptyline caused more severe cardiac effects in old than in young animals. However, plasma concentrations of nortriptyline in old rats were two to five times higher than those found in young rats at similar infusion rates. A higher concentration of the drug at its sites of action seems to be responsible for the more severe cardiac toxicity of nortriptyline observed in old rats.

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Section: Introductionmentioning

confidence: 99%