Biggs J T, Spiker D G, Petit J M, Ziegler V E
JAMA. 1977 Jul 11;238(2):135-8.
Forty consecutively hospitalized patients who had overdosed primarily with a tricyclic antidepressant (TCA) were observed until discharge. The severity of the overdose was documented by serial measurements of plasma TCA levels. Nineteen of the patients became comatose, 16 required supportive respiration, and 2 died. Individual symptoms in the 13 patients having plasma TCA levels greater than 1,000 ng/ml are shown. Plasma TCA measurements more reliably define patients who are at risk for major medical complications following overdose than does the amount of drug ingested by history. In the absence of plasma measurements, a QRS duration of 100 msec or more on a routine ECG within the first 24 hours defined all patients with major TCA overdoses.
连续观察了40例主要因过量服用三环类抗抑郁药（TCA）而住院的患者，直至出院。通过连续测量血浆TCA水平记录过量服用的严重程度。19例患者昏迷，16例需要辅助呼吸，2例死亡。列出了血浆TCA水平高于1000 ng/ml的13例患者的个体症状。与根据病史摄入的药物量相比，血浆TCA测量能更可靠地确定过量服用后有发生重大医疗并发症风险的患者。在没有血浆测量的情况下，最初24小时内常规心电图上QRS时限达100毫秒或更长可确定所有TCA过量服用的患者。
