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- เผยแพร่เมื่อ 9 ม.ค. 2016
- Tox Chalk Talk on TCA overdose from mechanisms to management.
Presented by Ran Ran, MD
Written by Ran Ran, MD, Gillian A. Beauchamp, MD, & Rob G. Hendrickson MD
Produced by EdCOMM, Oregon Health and Science University
Supported by the John C. Moorhead Endowment Fund
![[UNCUT] เพื่อไทยดันอุ๊งอิ๊งนั่งนายกฯ หลังเศรษฐาถูกถอดถอน | คนดังนั่งเคลียร์ | 15 ส.ค. 67](http://i.ytimg.com/vi/SpprmDJ6QEE/mqdefault.jpg)
Thank you for this amazing and beautiful presentation / explanation!
Ran this is an absolutely wonderful presentation. I like the organization and presentation style. I see a teaching in your future, as well as, Critical Care / EM. I love your organizational skills.
the music and voice made this video so engaging, i dont think ive ever seen a better combo of these in 100s of other medical videos
Beautiful presentation and explanation of the mode of toxicity. 5 STARS!!
This is a must view and understand for neurogastroenterologists who tend to recommend these drugs for IBS without simultaneously explaining toxicity even with seemingly "small doses"
Background music did a great job of holding my attention during what i would otherwise find to be very dry and boring info. Everything is better with music. Those who don't like it should be given lots of antidepressants! 😋😆
Interesting video and comments. So this is prescribed to depressed people (and other reasons), and can be used as a pain-free way to fall asleep for the last time. Nice :-)
A very thorough concise presentation. Thank you RR
Thankyou -this was a great help to me in assisting doctor in dx a suddenly agitated non verbal myoclonic patient
Subscribed! Great video set-up, I'm looking forward to viewing more of your videos!
Background music should not be there...
Excellent!
Fantastic
This is awesomely put together. You explained it so well! Could you do one like this on other types of overdoses?
I'm working on a toxic bradycardia one right now.
Britney Johnson I’m studying at Uni now and doing a hypothesis on Amitriptyline. What is the fatal dosage for an adult of 80kg (average BMI) and a 110kg (overweight male/female)? Thank you.
Excellent ver well done
Great one
thanks
I need a reference for the fact that TCAs block GABA receptors.
I looked in more than one book and in the internet but I couldn't find anything
Hey sorry, I didn't see your comment till now. Part of the difficulty in searching this topic is that most of the pharmaceutical papers use completely different names than what we use clinically. But here is what I got for your question: GABA-A-Receptor inhibition is listed as a mechanism under Lexicomp, and here are four papers from a quick search that looked at amitriptyline, imipramine, and mianserin on the GABA-R:
Malatynska E, Crites GJ, Harrawood D, Goldenberg R, Matheson GK. Antidepressant effects on GABA-stimulated 36Cl(-) influx in rat cerebral cortex are altered after treatment with GABA(A) receptor antisense oligodeoxynucleotides. Brain Res. 2000;869(1-2):78-84. PMID 10865061.
Malatynska E, Giroux ML, Dilsaver SC, Schwarzkopf SB. Chronic treatment with amitriptyline alters the GABA-mediated uptake of 36Cl- in the rat brain. Pharmacol Biochem Behav. 1991;39(2):553-6. PMID 1658820.
Malatynska E, Knapp RJ, Ikeda M, Yamamura HI. Antidepressants and seizure-interactions at the GABA-receptor chloride-ionophore complex. Life Sci. 1988;43(4):303-7. PMID 2456440.
Malatynska E, Miller C, Schindler N, et al. Amitriptyline increases GABA-stimulated 36Cl- influx by recombinant (alpha 1 gamma 2) GABAA receptors. Brain Res. 1999;851(1-2):277-80. PMID 10642857.
Excellent work man. I was asked about this in OSCE today, If I had seen your vid earlier, could have done better.
Thanks a lot.
What's the software that you used to make this vid btw?
42 YO female came in the ER today with suspected TCA overdose, went into Polymorphic VT and was barely shocked back into sinus rhythm. Definitely 'seven deadly sins'...
RonMD Hi. Is 8400mg of Amitriptyline a fatal amount to OD on? Found this hidden under daughters bed. She’s 110kg and 38. Thank you.
@@OfficialJGorman definitely
I took 12 pills at once about 7 months ago and I saw black and falled asleep when I wake up my head was hurting me.. I didnt tell the doctor. Do u think the pills will affect my health in the future? What can I do?
Now I know to wait when overdosing, last time I was found within 30 min :( hopefully this time it’ll work :)
Hey how are you? Are you still alive?
Sir please answer melitracen tricyclic antidesprent it is secondary amine
Do you have references for the potassium channel blockade?
Good one. But background music is very disturbing.
A friend of mine took 5000 mg of amitriptyline, evenly distributed in 30 minutes, after taking some alcohol.. I wonder, what must the subjective feeling be, when dying of this cause... Considering that broad range of neurotransmitter blocking, would one feel anything at all?
Yuki Ai Did it kill your friend? I survived a 3500mg OD on Amitriptyline but only because my partner acted within an hour of me taking them and I’m 100kg. And to answer your question I felt NOTHING. I fell asleep. Woke up a week later after being in an induced coma.
@@OfficialJGorman I see. Well, she was a PhD of psychiatry, and a doctor at a psychiatric hospital. It's the way she decided to commit suicide, when her loved one had betrayed her. Thing is, her weight must have been below 60 kg, and so, she had succeeded in her suicide. I have talked to her mother, and your experience is helpful to inform, that she must have felt "NOTHING". Thank you for sharing.
@@OfficialJGorman I'm 50kg and i have over 10,000mg of amitriptyline, is there any risk of survival??
@@sanaomer2828 I would firstly advise you to talk to someone. I’ve been in your shoes, I’ve asked these questions and then I’ve taken that overdose. I’m over weight and I only survived because the ex noticed something wasn’t right. 10000mg would kill you and most if you’re not found within an hour or maybe two; but please please reach out to someone and talk about how you’re feeling before you do anything like an overdose. Life will get better. Message me if you need a friend.
I am about 90 to 98 kgs ... What does will end it fast and painless?
Pls add more video!!!!!
Hi dr Ran, how similar to propranolol intoxication is this? I am medical student and like to hear some first hand experiences. Thanks
Check this out: th-cam.com/video/6DzyRwCEn3Q/w-d-xo.html. In real life, overdoses all present slightly differently. How much they take, polypharmacy, their physiology, down time, complications all add variability. In medicine, the best we can do is use concepts learned from physiology, cases, and randomized control trials to guide innovation in one hand tempered by skepticism in the other.
I've actually overdosed on trepiline
I tried an OD of 3500mg. Shouldn’t have survived but partner realised something wasn’t right and acted within an hour. I’ve since stored 8400mg and have a longer window alone. This should work???
You still here?
my freind took a whole month worth in one go and he is probably dead now
Galaxy Rage Unlikely. 1500mg can be fatal but I survived a 3500mg OD.
@@OfficialJGorman how
@@Anonymousmiranda12 I spent a week in a coma, and only survived because my now ex new something was off with me sneaking off to take them. Within an hour two ambulances were working on me. She was told to prepare for the worst. I’m a chunky build, that probably made the difference. Now got 13,000mg stored. I don’t feel I want to try again but I’m so up and down, it gives me a sense of control.
@@OfficialJGorman what was the pain like? Got 2 months worth and like 8 benzodiazepines...in deep contemplation
@@cortneypayton6473 No pain. With sleeping tablets I was unconscious within minutes and didn’t know a thing until I woke in hospital; but I do remember the near death experience and have clear memories of it. My life has dramatically improved with meditation, and finally developing as a spirit medium. Made some good friends, albeit online friends, and I feel like I have a purpose now - so you will again too. Please don’t take the OD, and message me if you need a friend to talk to. Don’t suffer alone.