小结
定义
病史和体格检查
关键诊断因素
- 存在的危险因素
- 精神状态改变
- 心动过速
- 低血压
- 瞳孔散大
- 皮肤发热、干燥、潮红
- 精神状态改变
- 肠鸣音减少或消失
- 尿潴留
- 眼部体征
- 神经系统体征
其他诊断因素
- 5-羟色胺综合征的特征
危险因素
- 抑郁史
- 强迫性障碍
- 慢性疼痛
- 注意缺陷多动障碍
诊断性检查
首要检查
- 心电图 (ECG)
- 碳酸氢钠尝试性治疗
- 动脉血气 (ABG)
需考虑的检查
- 血清三环类抗抑郁药浓度
- 血清中对乙酰氨基酚浓度
- 血清中水杨酸盐浓度
- 尿液药物筛查
治疗流程
疑似或证实三环类抗抑郁药过量
撰稿人
作者
Alastair Newton, MB ChB, FCEM
Staff Specialist in Emergency Medicine
Emergency Department
The Prince Charles Hospital
Brisbane
Queensland
Australia
利益声明
AN declares that he has no competing interests.
鸣谢
Dr Alastair Newton would like to gratefully acknowledge Dr Catherine Kelly and Dr Robert S. Hoffman, previous contributors to this topic. CK and RSH declare that they have no competing interests.
同行评议者
Edward Boyer, MD
Lecturer Pediatrics
The Children's Hospital
Boston
MA
利益声明
EB declares that he has no competing interests.
Ruben Thanacoody, MD, FRCP(Edin)
Consultant Physician and Clinical Toxicologist
National Poisons Information Service (Newcastle)
Newcastle-upon-Tyne
UK
利益声明
RT declares that he has no competing interests.
Laurie Prescott, MD, FRCP (Lond), FRCP (Edin), FFPM, FRSE
Emeritus Professor of Clinical Pharmacology
University of Edinburgh and Western General Hospital
Edinburgh
UK
利益声明
LP declares that he has no competing interests.
鉴别诊断
- 钠通道阻滞剂用药过量
- 导致心电图心电轴右偏的病症
- 抗胆碱能药物过量
更多 鉴别诊断指南
- 成人高级生命支持
- 2015 年欧洲复苏委员会 (European Resuscitation Council) 复苏指南
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