Yavuz OTAL, Aydın Deniz KARATAŞ, AHMET BAYDIN, ARİF ONUR EDEN

Ölümcül doz amitriptilin zehirlenmesi: Olgu sunumu

Yüksek doz amitriptilin alımına bağlı zehirlenme acil servise başvuru nedenleri arasında önemini korumaktadır. Özellikle 1 gramdan daha fazla alındığında, amitriptilin zehirlenmesi hayatı tehdit eden bir durum olmaktadır. Ölümlerin birçoğu alımdan sonraki ilk birkaç saat içinde meydana gelir. Yirmi üç yaşındaki bayan hasta 3 gram amitriptilin aldıktan sonra bilinç kaybı ile acil servisimize getirildi. Olguda kardiyopulmoner kollaps gelişmişti. Miyoklonik tarzda nöbet geçirmekteydi. Kan gazında derin asidozu mevcuttu. Endotrakeal entübasyon ve antiepileptik ilaçlar uygulandı. Asidozu nedeniyle bikarbonat verildi. Asidozunun düzelmemesi üzerine hemoperfüzyon uygulandı. Yoğun bakıma yatırılan hasta 2. gün tamamen düzeldi. Sonuç olarak amitriptilin yüksek doz alımları hayatı tehdit edici zehirlenmelere neden olabilmekle birlikte acil serviste uygulanacak doğru yaklaşımla olgular tamamen iyileşebilmektedir.

The fatal dose amitriptyline poisoning: Case report

High dose amitriptyline poisoning is very important condition among emergency department visits. Particularly more than one gram of amitriptilin exposure may cause mortality. Most of the deaths occur in several hours after taking amitripitilin. Twenty three year old woman patient applied our emergency department with a complaint of unconsciousness after three grams amitriptyline exposure. At the inital approach of the patient, it was seen that cardiopulmoner collaps and myoclonic seizure had been developed. At her blood gas analysis, there was profound metabolic asidosis. Endotracheal entubation and antiepileptic drugs were applied to the patient. Also bicarbonate was given for her profound metabolic asidosis. Because of the patient's acidosis did not improve with conservative treatment, hemoperfusion was applied to her. After two days follow up at intensive care unit, the patient recovered completely. As a conclusion, high dose amytriptilline poisoning is a serious case for emergency departments and can be fatal but appropriate evaluation and management of these cases at the emergency department can make patients recover rapidly.

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