Treatment Quality in Patients Poisoned With Tricyclic Antidepressants Admitted in Emergency Ward of Vali-E-Asr Hospital, Arak, Iran from March 2003 to May 2005

Introduction: Regarding the high rate of depression in our society, using anti-depressive drugs especially tricycle antidepressants (TCAs) is increasing and poisoning by these agents has become more common than other drugs. Due to its incident and dire complications we decided to study the treatment quality in poisoned patients with TCAss admitted in emergency ward of Arak,s Vali-e-Asr Hospital during March 2003 to May 2005. Material and methods: In this cross-sectional study, all patients poisoned by TCAs were admitted in emergency ward of Arak,s Vali-e-Asr Hospital. We assessed treatment modalities of them base on database questionnaire. Result: 112 patients (66 females and 46 males) entered the study. Concerning the severity of poisoning at the time of arrival to the hospital, 13 were healthy without any signs of intoxication, 64 had low poisoning, 21 had moderate poisoning and 14 cases presented with severe poisoning. Gastric lavage were performed for 49 cases, charcoal was prescribed for 85, ipecac syrup for 36, chest physiotherapy for 1 person and I/O checking for 35 cases. Conclusion: As for primary managements, routine procedures (serial ABG, ECG, heart monitoring and admitting in ICU) were done for most patients. In 32.1% of patients, ipecac syrup was prescribed nevertheless, it is contraindication for these patients and it was a serious mismanagement in their treatment. In total, we discovered that treatment modalities were not acceptable and preventive procedures were insufficient nonetheless, the mortality rate in this study was less than the rate of global statistics.