polypharmacy overdose see: [EM cases tox ECG](https://emergencymedicinecases.com/ecg-interpretation-toxicology/) ; [cubox link](cubox://card?id=7161409220800151586) [Utility of the electrocardiogram in drug overdose and poisoning: theoretical considerations and clinical implications.](bookends://sonnysoftware.com/ref/DL/80613) ![[Pasted image 20230630003636.png]] ![[Pasted image 20230630003654.png]] ![[Pasted image 20230630003703.png]] # TCA see: [[TCA overdose]], [[ECG]], # Sodium channel blocker - QRS prolongation - QT prolongation - terminal R wave in aVR (can be subtle) - low q-R ratio ## Causes * TCA * propranolol * flecanide * lignocaine * cocaine * lamotrigine * venlafaxine * hydroxchlorquine see: [[Sodium channel blocker]] # Digoxin - Ventricular ectopics - digoxin effect(down-sloping STD --> not toxicity, just shows cardiac clycoside - STE aVR - slow, features of AV block ## Treatment DigiFab indications for digivab: concerning ventricular issues (just bradycardia is not an indication) see: [[Digoxin toxicity]] # Long QT See [goldfrank QT interval](x-devonthink-item://2F041FBD-FF1C-4E21-9CD5-5550C288F006?page=277&istart=7959&ilength=10&search=QT%2520Interval) ## QT nomogram ![[Pasted image 20230518155817.png]] ## Drugs associated with QT prlongation see also: [[Long QT]] - sotolol (beta blocking and K+ blocking) - antipsychotics - SSRI - [[Amiodarone]] (hence why we do not use for tox!) - [ ] 47Q: [Large Citalopram Overdose](x-devonthink-item://834C484F-DDAA-4819-8DF0-84AE5E70DA1D?page=36) -- [Answer](x-devonthink-item://D46998FE-62E2-4A3A-860D-C32C94B86E42?page=17) -- [prop](x-devonthink-item://834C484F-DDAA-4819-8DF0-84AE5E70DA1D?page=77) - [ ] 71Q: [Polypharmacy Overdose](x-devonthink-item://1EA9311E-0B9E-49F7-8D6E-4C4187A838C4?page=36) -- [Answer](x-devonthink-item://B1CB2E8F-5D04-49EE-8274-043871389D28?page=24) - [ ] [Nightclub pills and cardiac ills](x-devonthink-item://6092BF31-E542-4019-8E17-0C628DD3B0F1?page=11) -- [Answer](x-devonthink-item://E15CEB64-C6A5-4A7D-84B4-E7D1DC667B0E?page=7) -- [Prop](x-devonthink-item://B3E266DE-B0B2-4F19-9986-B7C6FD455008?page=2)