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    Amitriptyline and perphenazine overdose

    Etrafon overdose; Triavil overdose; Triptazine overdose

    Amitriptyline and perphenazine is a combination drug that is sometimes prescribed for patients with depression, agitation, or anxiety.

    Amitriptyline and perphenazine overdose occurs when someone accidentally or intentionally takes more than the normal or recommended amount of this medication.

    This is for information only and not for use in the treatment or management of an actual poison exposure. If you have an exposure, you should call your local emergency number (such as 911) or the National Poison Control Center at 1-800-222-1222.

    See also: Amitriptyline overdose

    Poisonous Ingredient

    Amitriptyline and perphenazine

    Where Found

    • Etrafon
    • PMS-Levazine
    • Triavil
    • Triptazine

    Note: This list may not be all-inclusive.

    Symptoms

    • Airways and lungs
      • Breathing - slowed and labored
    • Bladder and kidneys
      • Urinary hesitancy
      • Inability to completely empty the bladder
    • Eyes, ears, nose, throat, and mouth
      • Blurred vision
      • Dry mouth
      • Enlarged pupils
      • Nasal congestion
      • Unpleasant taste
    • Heart and blood
      • Irregular heartbeat
      • Heartbeat - rapid
      • Low blood pressure (severe)
      • Shock
    • Muscles and joints
      • Muscle rigidity
      • Muscle spasms
      • Stiff muscles in neck, face, or back
    • Nervous system
      • Agitation
      • Coma
      • Convulsions
      • Disorientation
      • Drowsiness
      • Fever
      • Hypothermia (body temperature is lower than normal)
      • Restlessness
      • Seizures
      • Stupor (lack of alertness)
      • Uncoordinated movement
      • Tremor
      • Weakness
    • Reproductive system
      • Change in menstrual patterns
    • Skin
      • Itchy skin
      • Rash
    • Stomach and intestines
      • Constipation
      • Loss of appetite
      • Nausea
      • Vomiting

    Before Calling Emergency

    Determine the following information:

    • Patient's age, weight, and condition
    • Name of the product (ingredients and strengths, if known)
    • Time it was swallowed
    • Amount swallowed
    • Ifthe medication was prescribed for the patient

    Poison Control

    The National Poison Control Center (1-800-222-1222) can be called from anywhere in the United States. This national hotline number will let you talk to experts in poisoning. They will give you further instructions.

    This is a free and confidential service. All local poison control centers in the United States use this national number. You should call if you have any questions about poisoning or poison prevention. It does NOT need to be an emergency. You can call for any reason, 24 hours a day, 7 days a week.

    See: Poison control center - emergency number

    What to Expect at the Emergency Room

    The health care provider will measure and monitor the patient's vital signs, including temperature, pulse, breathing rate, and blood pressure. Symptoms will be treated as appropriate.

    The patient may receive:

    • Activated charcoal
    • Medicine (sodium bicarbonate) to reverse the effects of the overdose
    • Breathing support, including a breathing tube
    • Fluids through a vein (by IV)
    • Laxative
    • Tube from the mouth into the stomach to empty the stomach (gastric lavage)

    Outlook (Prognosis)

    This can be an extremely serious overdose. Death is possible. How well a patient does depends on how much of the drug was swallowed and how quickly medical treatment was received. The faster a patient receives medical help, the better the chance for recovery.

    Survival past 2 weeks is usually a good sign.

    References

    Brush DE, Aaron CK. Tricyclic and other cyclic antidepressants. In: Shannon MW, Borron SW, Burns MJ, eds. Haddad and Winchester's Clinical Management of Poisoning and Drug Overdose. 4th ed. Philadelphia, Pa: Saunders Elsevier; 2007:chap 27.

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          A Closer Look

            Tests for Amitriptyline and perphenazine overdose

              Review Date: 1/20/2010

              Reviewed By: Jacob L. Heller, MD, MHA, Emergency Medicine, Virginia Mason Medical Center, Seattle, Washington. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

              The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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