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a href="/orthopaedics-related-topics/medications/imipramine-tofranil/">Imipramine/a>br/>
 
 
 
 
a href="/orthopaedics-related-topics/medications/amitryipyline-elavil/">Amitriptyline/a>br/>
 
 
 
 
a href="/orthopaedics-related-topics/medications/doxepin-sinequan/">Doxepin/a>br/>
 
 
 
 
a href="/orthopaedics-related-topics/medications/nortriptyline-aventyl/">Nortriptyline/a>br/>
 
 
 
 
a href="/orthopaedics-related-topics/medications/protriptyline-vivactil/">Protriptyline/a>br/>
 
 
 
 
Trimipraminebr/>
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b>- Discussion:/b>br/>
 
 
- b>anticholinergic crisis/b> in w/ antidepressant overdose presents as:br/>
 
 
 
 
 
- mydriasis, blurred vision, urinary retension, dry mucous membranes,br/>
 
 
 
 
 
 
 
 
constipation, ileus, sinus tachycardia, hyperthermia or hypothermia,br/>
 
 
 
 
 
 
 
 
confusion, agitation, and hallucinations;br/>
 
 
 
 
 
- b>acidosis/b> potentiates TCA toxicity;br/>
 
 
 
 
 
 
 
 
 
- respiratory acidosis is treated w/ intubation and hyperventilation;br/>
 
 
- b>drug interactions:/b>br/>
 
 
 
 
 
- b>anesthetic agents:/b>br/>
 
 
 
 
 
 
 
 
- combination of halothane, pancuronium, & tricyclic antidepressants,br/>
 
 
 
 
 
 
 
 
 
 
 
 
can cause severe ventricular arrhythmias;br/>
 
 
 
 
 
- interaction w/ b>neuroleptic agents, /b>br/>
 
 
 
 
 
 
 
 
- combination of drugs should be especially avoided in the elderly;br/>
 
 
 
 
 
 
 
 
- least potent antipsychotics (a href="/orthopaedics-related-topics/medications/chlorpromazine-thorazine/">Chlorpromazine/a> & a href="/orthopaedics-related-topics/medications/thioridazine-mellaril/">Thioridazine/a> tend tobr/>
 
 
 
 
 
 
 
 
 
 
 
 
be most sedating and to have most b>anticholinergic effects/b>;br/>
 
 
 
 
 
 
 
 
- use of such drugs in combination w/ antidepressant that also hasbr/>
 
 
 
 
 
 
 
 
 
 
 
 
high anticholinergic activity may cause toxic anticholinergicbr/>
 
 
 
 
 
 
 
 
 
 
 
 
reactions, including delirium;br/>
 
 
 
 
 
 
 
 
- autonomic side effects are also relatively frequent w/ lessbr/>
 
 
 
 
 
 
 
 
 
 
 
 
potent neuroleptics, & resultant b>hypotensive episodes/b> maybr/>
 
 
 
 
 
 
 
 
 
 
 
 
predispose to falls, myocardial infarction, or CVA;br/>
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