Arterial Blood Gas Analysis and the Outcome of Treatment in Tricyclic Antidepressants Poisoned Patients with Benzodiazepine Coingestion

Background. Poisoning with tricyclic antidepressants (TCAs) is still a major concern for emergency physicians and intensivists. Concomitant ingestion of other psychoactive drugs especially benzodiazepines with TCAs may make this clinical situation more complex. This study aimed to compare the arteri...

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Main Authors: Ahmad Yaraghi, Nastaran Eizadi-Mood, Maryam Katani, Shadi Farsaei, Mahrang Hedaiaty, Seyyed Mohammad Mahdy Mirhosseini, Elham Beheshtian, Ali Mohammad Sabzghabaee
Format: Article
Language:English
Published: Wiley 2015-01-01
Series:Anesthesiology Research and Practice
Online Access:http://dx.doi.org/10.1155/2015/232401
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author Ahmad Yaraghi
Nastaran Eizadi-Mood
Maryam Katani
Shadi Farsaei
Mahrang Hedaiaty
Seyyed Mohammad Mahdy Mirhosseini
Elham Beheshtian
Ali Mohammad Sabzghabaee
author_facet Ahmad Yaraghi
Nastaran Eizadi-Mood
Maryam Katani
Shadi Farsaei
Mahrang Hedaiaty
Seyyed Mohammad Mahdy Mirhosseini
Elham Beheshtian
Ali Mohammad Sabzghabaee
author_sort Ahmad Yaraghi
collection DOAJ
description Background. Poisoning with tricyclic antidepressants (TCAs) is still a major concern for emergency physicians and intensivists. Concomitant ingestion of other psychoactive drugs especially benzodiazepines with TCAs may make this clinical situation more complex. This study aimed to compare the arterial blood gas (ABG) values and the outcome of treatment in patients with coingestion of TCA and benzodiazepine (TCA + BZD) poisoning and TCA poisoning alone. Methods. In this cross-sectional study which was carried out in a tertiary care university hospital in Iran, clinical and paraclinical characteristics of one hundred forty TCA only or TCA + BZD poisoned patients (aged 18–40 years) were evaluated. ABG analysis was done on admission in both groups. Outcomes were considered as survival with or without complication (e.g., intubation) and the frequency of TCA poisoning complications. Results. Arterial pH was significantly lower in TCA + BZD poisoning group compared with TCA only poisoning group (7.34 ± 0.08 and 7.38 ± 0.08, resp.; P=0.02). However, other complications such as seizure, and the need for the endotracheal intubation were not significantly different. All patients in both groups survived. Conclusions. Concomitant TCA plus BZD poisoning may make the poisoned patients prone to a lower arterial pH level on hospital admission which may potentially increases the risk of cardiovascular complications in TCA poisoning.
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spelling doaj-art-28f0e079e66c4854996a166848272ed82025-02-03T01:27:44ZengWileyAnesthesiology Research and Practice1687-69621687-69702015-01-01201510.1155/2015/232401232401Arterial Blood Gas Analysis and the Outcome of Treatment in Tricyclic Antidepressants Poisoned Patients with Benzodiazepine CoingestionAhmad Yaraghi0Nastaran Eizadi-Mood1Maryam Katani2Shadi Farsaei3Mahrang Hedaiaty4Seyyed Mohammad Mahdy Mirhosseini5Elham Beheshtian6Ali Mohammad Sabzghabaee7Department of Anesthesiology and Critical Care, School of Medicine, Isfahan University of Medical Sciences, Isfahan, IranIsfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, IranDepartment of Clinical Toxicology, Noor and Ali Asghar (PBUH) University Hospital, Isfahan University of Medical Sciences, Isfahan, IranDepartment of Clinical Pharmacy and Pharmacy Practice, School of Pharmacy and Pharmaceutical Sciences, Isfahan University of Medical Sciences, Isfahan, IranDepartment of Clinical Toxicology, Noor and Ali Asghar (PBUH) University Hospital, Isfahan University of Medical Sciences, Isfahan, IranDepartment of Clinical Toxicology, Noor and Ali Asghar (PBUH) University Hospital, Isfahan University of Medical Sciences, Isfahan, IranDepartment of Clinical Toxicology, Noor and Ali Asghar (PBUH) University Hospital, Isfahan University of Medical Sciences, Isfahan, IranIsfahan Clinical Toxicology Research Center, Isfahan University of Medical Sciences, Isfahan, IranBackground. Poisoning with tricyclic antidepressants (TCAs) is still a major concern for emergency physicians and intensivists. Concomitant ingestion of other psychoactive drugs especially benzodiazepines with TCAs may make this clinical situation more complex. This study aimed to compare the arterial blood gas (ABG) values and the outcome of treatment in patients with coingestion of TCA and benzodiazepine (TCA + BZD) poisoning and TCA poisoning alone. Methods. In this cross-sectional study which was carried out in a tertiary care university hospital in Iran, clinical and paraclinical characteristics of one hundred forty TCA only or TCA + BZD poisoned patients (aged 18–40 years) were evaluated. ABG analysis was done on admission in both groups. Outcomes were considered as survival with or without complication (e.g., intubation) and the frequency of TCA poisoning complications. Results. Arterial pH was significantly lower in TCA + BZD poisoning group compared with TCA only poisoning group (7.34 ± 0.08 and 7.38 ± 0.08, resp.; P=0.02). However, other complications such as seizure, and the need for the endotracheal intubation were not significantly different. All patients in both groups survived. Conclusions. Concomitant TCA plus BZD poisoning may make the poisoned patients prone to a lower arterial pH level on hospital admission which may potentially increases the risk of cardiovascular complications in TCA poisoning.http://dx.doi.org/10.1155/2015/232401
spellingShingle Ahmad Yaraghi
Nastaran Eizadi-Mood
Maryam Katani
Shadi Farsaei
Mahrang Hedaiaty
Seyyed Mohammad Mahdy Mirhosseini
Elham Beheshtian
Ali Mohammad Sabzghabaee
Arterial Blood Gas Analysis and the Outcome of Treatment in Tricyclic Antidepressants Poisoned Patients with Benzodiazepine Coingestion
Anesthesiology Research and Practice
title Arterial Blood Gas Analysis and the Outcome of Treatment in Tricyclic Antidepressants Poisoned Patients with Benzodiazepine Coingestion
title_full Arterial Blood Gas Analysis and the Outcome of Treatment in Tricyclic Antidepressants Poisoned Patients with Benzodiazepine Coingestion
title_fullStr Arterial Blood Gas Analysis and the Outcome of Treatment in Tricyclic Antidepressants Poisoned Patients with Benzodiazepine Coingestion
title_full_unstemmed Arterial Blood Gas Analysis and the Outcome of Treatment in Tricyclic Antidepressants Poisoned Patients with Benzodiazepine Coingestion
title_short Arterial Blood Gas Analysis and the Outcome of Treatment in Tricyclic Antidepressants Poisoned Patients with Benzodiazepine Coingestion
title_sort arterial blood gas analysis and the outcome of treatment in tricyclic antidepressants poisoned patients with benzodiazepine coingestion
url http://dx.doi.org/10.1155/2015/232401
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