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In those who have a wide QRS complex (> 100 ms) sodium bicarbonate is recommended. [2] If seizures occur benzodiazepines should be given. [2] In those with low blood pressure intravenous fluids and norepinephrine may be used. [1] The use of intravenous lipid emulsion may also be tried. [3]
Tricyclic antidepressant (TCA) overdose can lead to cardiac arrest with typical ECG findings including wide QRS and prolonged QTc. Treatment for this condition includes activated charcoal and sodium bicarbonate. [120] Magnesium can be given at a does of 2 g (iv or oral bolus) to manage torsades de points.
Acidosis (hydrogen cation excess) is an abnormal pH in the body as a result of lactic acidosis which occurs in prolonged hypoxia and in severe infection, diabetic ketoacidosis, kidney failure causing uremia, or ingestion of toxic agents or overdose of pharmacological agents, such as aspirin and other salicylates, ethanol, ethylene glycol and other alcohols, tricyclic antidepressants, isoniazid ...
Class III antiarrhythmic drugs are potassium channel blockers that cause QT prolongation and are associated with TdP. Amiodarone. Amiodarone works in many ways. It blocks sodium, potassium, and calcium channels, as well as alpha and beta adrenergic receptors. Because of its multiple actions, amiodarone causes QT prolongation but TdP is rarely ...
Intravenous sodium bicarbonate is indicated in the treatment of metabolic acidosis, such as can occur in severe kidney disease, diabetic ketoacidosis [citation needed], circulatory insufficiency, extracorporeal circulation of blood, in hemolysis requiring alkalinization of the urine to avoid nephrotoxicity of blood pigments, and certain drug intoxications, such as by barbiturate overdose ...
Modalities that have had success include administration of a beta-sympathomimetic agent, [19] and administration of a sodium load [19] (often in the form of hypertonic sodium bicarbonate). Placing the individual on cardiopulmonary bypass support may be necessary in order to temporarily remove the need for a beating heart and to increase blood ...
If there is metabolic acidosis, intravenous infusion of sodium bicarbonate is recommended by Toxbase.org, the UK and Ireland poisons advice database (TCAs are protein bound and become less bound in more acidic conditions, so by reversing the acidosis, protein binding increases and bioavailability thus decreases – the sodium load may also help ...
QRS duration: 75 to 105 ms [3] Shorter in children [4] Prolonged duration could indicate hyperkalemia [5] or intraventricular conduction delay such as bundle branch block. QRS amplitude: S amplitude in V1 + R amplitude in V5 < 3.5 millivolt (mV) [4] R+S in a precordial lead < 4.5 mV [4] R in V5 or V6 < 2.6 mV; Increased amplitude indicates ...