Welcome to Episode 148 of the Nursing Show
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This Week- Antidepressant Overdose with Lisa Booze of the Maryland Poison Center
The different classifications of antidepressants are:
- Selective Serotonin Reuptake Inhibitors (SSRI)
- eg. Prozac (fluoxetine), Paxil (paroxetine)
- Serotonin and Norepinephrine Reuptake Inhibitors (SSNIs)
- eg. )Effexor (venlafaxine), Cymbalta (duloxetine)
- Tricyclic antidepressants (TCAs)
- eg. Elavil (amitriptyline), Tofranil (imipramine)
- Monoamine Oxidase Inhibitors (MAOIs)
- eg. Nardil (phenelzine), Parnate (tranylcypromine)
SSRI’s are regarded as first-line therapy for depression but TCAs remain to be widely used not only for depression but also for other conditions like anxiety disorders, ADD, pediatric enuresis and chronic pain disorders. Overdose from TCAs are among the most common causes of drug poisoning seen in emergency departments.
Tricyclics are identified as one of the most frequently ingested substances in poisoning along with paracetamol, benzodiazepines and alcohol. They are second to analgesics as most common drug taken in fatal drug overdose.
Management of antidepressant overdose includes measures to reduce absorption, alkalinisation, providing anti-arrhythmic treatment, management of hypotension and convulsions. Patients should also be closely monitored for risk of cardiac arrest and seizure precautions should be instituted.
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Song this week:
Matthew Ebel with “Downtown”
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