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

Cardiovascular Toxicology volume 18, pages 547–556 (2018)Cite this 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.

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Authors and Affiliations

  1. Department of Emergency Medicine, Atatürk Training and Research Hospital, İzmir Katip Çelebi University, Izmir, Turkey

    Saylav Bora

  2. Department of Physiology, Faculty of Medicine, İzmir Katip Çelebi University, Izmir, Turkey

    Mümin Alper Erdoğan

  3. Department of Histology and Embryology, Muğla Sıtkı Koçman University, Muğla, Turkey

    Gürkan Yiğittürk

  4. Department of Physiology, Faculty of Medicine, Istanbul Bilim University, Istanbul, Turkey

    Oytun Erbaş

  5. Department of Emergency Medicine, Health Science University İzmir Bozyaka Research and Training Hospital, Izmir, Turkey

    İsmet Parlak

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Bora, S., Erdoğan, M.A., Yiğittürk, G. et al. The Effects of Lipid Emulsion, Magnesium Sulphate and Metoprolol in Amitriptyline-Induced Cardiovascular Toxicity in Rats. Cardiovasc Toxicol 18, 547–556 (2018). https://doi.org/10.1007/s12012-018-9466-y

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Keywords

  • Drug toxicity
  • QTc
  • Amitriptyline
  • Arrhythmia
  • Electrocardiogram