A patient taking amitriptyline (Elavil) is brought to the emergency department confused and agitated. As time progresses, her assessment reveals a heart rate of 120/minute, temperature 104° F, flushing, mydriasis, and blood pressure 170/90
Based on her assessment, which of the fol-lowing would be the nurse's priority action? a. Gastric lavage, activated charcoal, and physostigmine
b. Epinephrine and propranolol (Inderal)
c. Gastric lavage, activated charcoal
d. Cool IV fluids and a cooling blanket
A
Amitriptyline overdose should be suspected based on the patient's assessment findings. The pa-tient should be treated with gastric lavage, followed by ingestion of activated charcoal, which will bind with the medication so that it is removed from the body. Physostigmine is given to counteract the anticholinergic actions of the amitriptyline.
Epinephrine and propranolol are not indicated as treatment for amitriptyline overdose. There is no reason to suspect that alcohol toxicity is the issue.
Physostigmine should be included as part of the management of amitriptyline overdose.
Bringing down the patient's temperature is not indicated for amitriptyline overdose.
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