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Case Reports of Successful Therapeutic Plasma Exchange in Severe Amitriptyline Poisoning
Author(s) -
Bayrakci Benan,
Unal Sule,
Erkocoglu Mustafa,
Güngör Handan Yüksel,
Aksu Salih
Publication year - 2007
Publication title -
therapeutic apheresis and dialysis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.415
H-Index - 53
eISSN - 1744-9987
pISSN - 1744-9979
DOI - 10.1111/j.1744-9987.2007.00527.x
Subject(s) - amitriptyline , medicine , gastric lavage , coma (optics) , sodium bicarbonate , anesthesia , hemoperfusion , metabolic acidosis , ingestion , acidosis , hemodialysis , chemistry , physics , optics
Severe amitriptyline toxicity may cause coma, hypotension, convulsions, supraventricular and ventricular arrhythmias, metabolic/respiratory acidosis and cardiac arrest. Management with gastric lavage, activated charcoal, alkalinization with sodium bicarbonate and supportive care with mechanical ventilation, antiarrhythmics and anticonvulsants if required, is the common approach. Herein, we report successful treatment of severe amitriptyline poisoning in three cases by plasma exchange in addition to the above supportive measures. Plasma exchange may have a beneficial role in lethal doses of amitriptyline ingestion because of the high plasma protein binding property of amitriptyline.