症例 challenge · Emergency / Toxicology / Critical care · teaching

Tricyclic Antidepressant Poisoning — Management Pathway · case challenge

Given a case, work through the care pathway step by step; the tool checks each choice and scores you. Decisions and basis are taken from this site's reviewed care pathways.

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Case #1Emergency / Toxicology / Critical care

📋 Case data

Cardiotoxicity?QRS >100 ms / ventricular arrhythmia / hypotension

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Step 1 / 1 · Cardiotoxicity?

Cardiotoxicity / QRS widening?

💡 Tricyclics (amitriptyline, etc.) block sodium channels → QRS widening (>100 ms predicts seizures, >160 ms predicts ventricular arrhythmia), an R wave in aVR; with anticholinergic features (mydriasis, tachycardia, dry flushed skin, delirium), alpha-blockade hypotension, seizures, coma. Judge by ECG and clinical features; drug levels are of limited value.

For teaching. Decisions and their basis are taken from this site's reviewed care pathways; for licensed clinicians/trainees, this does not replace clinical judgment or local protocols.