Guharoy S R
Pharmacy Services, John F Kennedy Memorial Hospital, Indio, CA 92201.
Vet Hum Toxicol. 1994 Aug;36(4):316-7.
Adult respiratory distress syndrome (ARDS) from overdose of tricyclic antidepressants (TCA) has been rarely reported in the literature. We describe a case report of ARDS secondary to amitriptyline overdose. A 39-y-old comatose female was admitted to the emergency department after ingesting approximately 2 g of amitriptyline 1-12 h prior to arrival. Patient was intubated and physostigmine was administered. There was only minimal level of improvement in the patient's consciousness. Gastric lavage was followed by charcoal and magnesium citrate; no material was recovered from the stomach. The patient was transferred to the intensive care unit and placed on a ventilator. Chest radiographic study on day 2 of hospital admission revealed bilateral diffuse opacity typical of ARDS. In the intensive care unit the patient developed metabolic acidosis and hypotension, and they were treated aggressively. The patient's chest radiograph was normal after 5 d; she was discharged from the hospital after 12 d. Though there are few reports of ARDS secondary to TCA, clinicians should be aware of this potential.
三环类抗抑郁药（TCA）过量导致成人呼吸窘迫综合征（ARDS）的病例在文献中鲜有报道。我们描述了一例因阿米替林过量继发ARDS的病例报告。一名39岁昏迷女性在入院前1 - 12小时摄入约2克阿米替林后被送往急诊科。患者接受了气管插管并注射了毒扁豆碱。患者意识仅有轻微改善。洗胃后给予活性炭和枸橼酸镁；胃内未发现残留物质。患者被转入重症监护病房并使用呼吸机。入院第2天的胸部X线检查显示出典型的ARDS双侧弥漫性模糊影。在重症监护病房，患者出现代谢性酸中毒和低血压，并接受了积极治疗。患者胸部X线片在5天后恢复正常；12天后出院。尽管TCA继发ARDS的报道较少，但临床医生应意识到这种可能性。
