The comprasion of the medication taken in anticholinergic toxicity with the clinic state and the electrocardiographic findings of patient

The Comparison Of The Medication Taken In Anticholinergic Toxicity With TheClinic State and The Electrocardiographic Findings Of PatientObjective: Most of the applications to emergency rooms because of toxicity arerelated to drugs and anticholinergic drugs, especially tricyclic antidepressants, take animportant place. Because anticholinergic drug toxicities affect heart delivery system andcentral nervous system (consciousness state changes, seizures); immediate diagnosisand treatment minimize the damage. In our study, we have aimed to make a comparisonbetween the type and dose of the drug causing the anticholinergic toxicity andelectrocardiographic findings and to specify the efficiency of this in diagnosis andtreatment.Method: In our study which was planned as a prospective study, the patientswho applied to the emergency room with the complaint of taking anticholinergic drugsin dates between 02/06/2010-01/06/2011 were evaluated. Demographic data, clinic andelectrocardiographic findings of the patients and the data from toxicology laboratorywere recorded and analyzed 31 female (70,5%), 13 male (29,5%), total 44 patients withvarious ages between 17 and 78 were selected for the study.Results: No drug was detected in blood samples of 22 of the patients (50%)while amitriptyline was detected in 10 patients (23%) and other drugs withanticholinergic effect were detected in 12 (27%). Average duration between drug intakeand application to the service was 3,3 hours. 90,4% of the patients came to the servicewith referrals from other health facilities. Various cardiac pathologies, especially sinustachycardia have been detected in the patients while no difference was detected betweengroups. The Glasgow coma scale of the patients receiving amitriptyline was foundsignificantly low (p<0,005). The drug levels of the patients with amitriptyline detectedin their blood and the clinic and ECG findings were understood to be unrelated. Heartrate and QT distance was found significantly low after treatment in all groups. All of thepatients who were observed and received treatment in emergency room were healed anddischarged.Conclusion: Tricyclic antidepressant toxicities have effects on heart rhythm.However, when a comparison of drug groups was made in our study, the consciousnessstate change of the group receiving amitriptyline was statistically significantly affectedwhile no serious cardiac influence affecting hemodynamic findings was seen.Keywords: Amitriptyline, Anticholinergic toxicity, Glaskow Coma Scale, Heartinfluence