A Literature Review of the Use of Sodium Bicarbonate for the Treatment of QRS Widening
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- 作者：Rebecca E. Bruccoleri ; Michele M. Burns
- 关键词：Sodium bicarbonate ; Electrocardiogram ; QRS widening ; Tricyclic antidepressants
- 刊名：Journal of Medical Toxicology
- 出版年：2016
- 出版时间：March 2016
- 年：2016
- 卷：12
- 期：1
- 页码：121-129
- 全文大小：226 KB
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Michele M. Burns (1)
1. Harvard Medical Toxicology Fellowship, Division of Emergency Medicine, Program in Medical Toxicology, Boston Children’s Hospital, 300 Longwood Avenue, Boston, MA, 02115, USA - 刊物主题：Pharmacology/Toxicology; Biomedicine general;
- 出版者：Springer US
- ISSN：1937-6995
文摘
Sodium bicarbonate is a well-known antidote for tricyclic antidepressant (TCA) poisoning. It has been used for over half a century to treat toxin-induced sodium channel blockade as evidenced by QRS widening on the electrocardiogram (ECG). The purpose of this review is to describe the literature regarding electrophysiological mechanisms and clinical use of this antidote after poisoning by tricyclic antidepressants and other agents. This article will also address the literature supporting an increased serum sodium concentration, alkalemia, or the combination of both as the responsible mechanism(s) for sodium bicarbonate’s antidotal properties. While sodium bicarbonate has been used as a treatment for cardiac sodium channel blockade for multiple other agents including citalopram, cocaine, flecainide, diphenhydramine, propoxyphene, and lamotrigine, it has uncertain efficacy with bupropion, propranolol, and taxine-containing plants.