A 27-year-old woman is brought to the emergency department after ingesting an unknown amount of amitriptyline 2 hours ago. She is confused and disoriented. Vital signs show BP 85/52 mmHg, HR 118/min, RR 22/min, temperature 37.8°C, and SpO2 98% on room air. ECG demonstrates a QRS duration of 160 ms. Serum bicarbonate is 22 mEq/L. She denies acetaminophen ingestion. Which of the following is the most appropriate treatment?
- A)N-acetylcysteine
- B)Physostigmine
- C)Haloperidol
- D)Sodium bicarbonateGABARITO
- E)Flumazenil
Explicação
Tricyclic antidepressant overdose causes anticholinergic findings, hypotension, and potentially fatal sodium channel blockade with QRS widening and arrhythmias. Sodium bicarbonate is given to narrow the QRS and reduce cardiotoxicity. Ver explicação completa e trilha adaptativa →