Tricyclic antidepressant overdose

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Tricyclic antidepressant TCA e.g. amitryptyline overdose shows anticholinergic effect. 
More serious side effects:

Conclusion
Coma
Hypotension
Tachyarrhythmia with QRS prolong
Cardiorespiratory collapse
Metabolic acidosis


IV sodium bicarbonate should be considered if presence of:

Systemic acidosis
QRS >160ms
Ventricular arrhythmia
Hypotension
Cardiac arrest


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