1. There is no specific treatment for tricyclic antidepressant poisoning.

2. Patients require ECG monitoring during the first 24h and until ECG changes have disappeared for 12h.

3. Gastric elimination is worthwhile for 24h after ingestion since tricyclics slow gastric emptying.

4. Activated charcoal via a nasogastric tube will adsorb tricyclics remaining in the bowel.

5. Cardiac arrhythmias are more common if there is acidosis. Bicarbonate should be used to achieve an arterial pH of 7.5 urgently. If arrhythmias occur with no acidosis and fail to respond to treatment with amiodarone or phenytoin, bicarbonate (25-50ml 8.4% IV) may still be useful.

6. Seizures are best managed with benzodiazepines and phenytoin.


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Eliminating Stress and Anxiety From Your Life

It seems like you hear it all the time from nearly every one you know I'm SO stressed out!? Pressures abound in this world today. Those pressures cause stress and anxiety, and often we are ill-equipped to deal with those stressors that trigger anxiety and other feelings that can make us sick. Literally, sick.

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