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The Effects of Lipid Emulsion, Magnesium Sulphate and Metoprolol in Amitriptyline-Induced Cardiovascular Toxicity in Rats

  • Saylav Bora
  • Mümin Alper Erdoğan
  • Gürkan Yiğittürk
  • Oytun Erbaş
  • İsmet Parlak
Article

Abstract

The aim of this study was to evaluate the effects of metoprolol, lipid emulsion and MgSO4 which can be recommended for prevention of long QT that is one of the lethal consequences of amitriptyline intoxication. Thirty Sprague–Dawley male rats were included. Five groups respectively received the following: saline intraperitoneally (i.p.); amitriptyline (AMT) 100 mg/kg per os (p.o.) and saline i.p.; AMT 100 mg/kg p.o. and 5 mg/kg metoprolol i.p.; AMT 100 mg/kg p.o. and 20 ml/kg lipid emulsion i.p.; AMT 100 mg/kg p.o. and 75 mg/kg MgSO4 i.p. After 1 h, all groups were analysed by ECG recordings in DII lead; their blood was taken for biochemical examination and euthanasia was performed. For histological examination, cardiac tissues were removed and sections were prepared. QTc was significantly reduced in treatment groups compared to the AMT+saline group. When compared with the AMT+saline, lipid emulsion did not affect pro-BNP and troponin levels in biochemical analysis, but it significantly reduced Caspase 3 expression in histological examination. In the group treated with AMT and metoprolol, there was no significant effect on Caspase 3 expression. In MgSO4-treated group, there was a significant decrease in troponin, pro-BNP and urea levels biochemically and significant decrease in Caspase 3 expression histologically when compared with the control group. With further studies including clinical studies, MgSO4, lipid emulsion or metoprolol may be used to improve AMT-induced cardiotoxicity. They can possibly become alternative approaches in the future for suicidal or accidental intoxication of tricyclic antidepressant in emergency departments.

Keywords

Drug toxicity QTc Amitriptyline Arrhythmia Electrocardiogram 

Notes

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. 1.Department of Emergency Medicine, Atatürk Training and Research Hospitalİzmir Katip Çelebi UniversityIzmirTurkey
  2. 2.Department of Physiology, Faculty of Medicineİzmir Katip Çelebi UniversityIzmirTurkey
  3. 3.Department of Histology and EmbryologyMuğla Sıtkı Koçman UniversityMuğlaTurkey
  4. 4.Department of Physiology, Faculty of MedicineIstanbul Bilim UniversityIstanbulTurkey
  5. 5.Department of Emergency MedicineHealth Science University İzmir Bozyaka Research and Training HospitalIzmirTurkey

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