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NURS 6261 90L University of Texas Rio Tricyclic Antidepressant Toxicity in Geriatric Patient Paper

NURS 6261 90L University of Texas Rio Tricyclic Antidepressant Toxicity in Geriatric Patient Paper

Question Description

The other instructor did it but i don’t like it . it does not address the issue.

1) Please review the case study attached.

2) review requirement and grading rubric

3) add plan for treatment option in the introduction using the following :

(Treatment and management)

(Proper management of airway, breathing, and circulation is critical in cases of TCA poisoning. Gastrointestinal decontamination by activated charcoal should be done only if conditions are appropriate and the airway is protected. Charcoal decontamination may be effective up to 2 hours’ post-ingestion, especially if the bowel sounds are diminished. Every effort should be made to minimize the formation of acidosis, as acidosis may increase cardiac and neurologic toxicity. Seizures usually respond to benzodiazepines, but in cases of refractory seizures, prompt administration of anticonvulsants, such as phenobarbital or propofol, or even general anesthesia, should be considered. Sodium bicarbonate should be given to hemodynamically unstable patients, patients with seizures, and patients with QRS prolongation of more than 100 msec. Sodium bicarbonate is given as a bolus of 1 meq/kg, followed by an intravenous infusion containing sodium bicarbonate. The aim of this therapy is to narrow the QRS and to keep the serum pH between 7.5 and 7.55. Hypotensive patients should be treated with IV fluids and sodium bicarbonate, and if their hypotension does not respond to this, alpha-adrenergic agents, such as norepinephrine, should be used. Sodium bicarbonate should be used to treat dysrhythmias associated with QRS widening. Temporary pacemakers have been used to treat refractory symptomatic bradycardias not responsive to sodium bicarbonate. Physostigmine, Type 1A, Type 1C, and Type 3 Anti-dysrhythmic agents should be strictly avoided, as should Flumazenil. Intralipid emulsion treatment should be considered in hemodynamically unstable patients with overdoses of lipophilic TCAs. Since TCA are highly protein bound with an extensive volume of distribution, enhanced elimination with dialysis and hemoperfusion is not effective.

4) use this article to propose the treatment options, insert addition paragraph on the assignment that will take this article in consideration (its probably the most important article of this assignment). insert all the treatment option listed in this article in the introduction as required by the assignment. (see attached). also insert new paragraph in the annotated biography that address this article.

Khalid MM, Waseem M. Tricyclic Antidepressant Toxicity. In: StatPearls. Treasure Island (FL): StatPearls Publishing; 2020


Your Annotated Bibliography assignment is the evidential foundation for your Case Study Presentation assignment. In this assignment, students will pick a case study, diagnose the patient, and present a plan for treatment options.

Select at least six current original research articles published within the last five years to support your treatment plan. For each article, place each article reference in APA format and write a summary that includes a) the purpose of the research, b) sample information, c) statistical significant or trustworthy results related to your practice change, d) recommendations made by the author(s), and e) your personal comments about the quality of the article. Submit this assignment using the respective link by the due date in Black.

Further Explanation:


An annotated bibliography is a list of citations to books, articles, and documents. Each citation is followed by a brief (usually about 150 words) descriptive and evaluative paragraph, the annotation. The purpose of the annotation is to inform the reader of the relevance, accuracy, and quality of the sources cited.


Abstracts are the purely descriptive summaries often found at the beginning of scholarly journal articles or in periodical indexes. Annotations are descriptive and critical; they expose the author’s point of view, clarity and appropriateness of expression, and authority.


Creating an annotated bibliography calls for the application of a variety of intellectual skills: concise exposition, succinct analysis, and informed library research.

First, locate and record citations to books, periodicals, and documents that may contain useful information and ideas on your topic. Briefly examine and review the actual items. Then choose those works that provide a variety of perspectives on your topic.

Cite the book, article, or document using the appropriate style, APA.

Write a concise annotation that summarizes the central theme and scope of the book or article. Include one or more sentences that (a) evaluate the authority or background of the author, (b) comment on the intended audience, (c) compare or contrast this work with another you have cited, or (d) explain how this work illuminates your bibliography topic.

Use the Same Topic as your Case Presentation and Professional paper (Don’t re-invent the wheel)


Khalid, M. M., & Waseem, M. (2020). Tricyclic Antidepressant Toxicity. In StatPearls. StatPearls Publishing.


Tricyclic antidepressants (TCAs) were introduced in the late 1950s for the treatment of depression. However, with the advent of selective serotonin reuptake inhibitors (SSRIs) and other new antidepressants, the use of TCAs has become limited, although it is still used to treat depression that has not responded to treatment with less toxic agents. In adults, TCAs are also used in migraine headache prophylaxis, treatment of neuralgic pain, including the pain associated with Ciguatera poisoning, and obsessive-compulsive disorder. In children, TCAs have been used to treat nocturnal enuresis. Despite the current limited use of TCAs, the curve for TCA-overdose associated hospitalization and fatality is on the rise.

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