Efficacy of dopamine and norepinephrine for treatment of hemodynamic compromise in amitriptyline intoxication.

Abstract

Dopamine and norepinephrine were evaluated for treatment of hemodynamic compromise in amitriptyline intoxication. Fifteen anesthetized dogs underwent hemodynamic monitoring and amitriptyline intoxication, and received three infusion rates of dopamine (5, 15, and 30 micrograms/kg.min) and three infusion rates of norepinephrine (0.25, 0.5, and 1.0 micrograms/kg.min), sequentially, with hemodynamic measurements at each dose. Data were analyzed using repeated-measures analysis of variance; p less than .05 was considered significant. Amitriptyline intoxication lowered cardiac output, peak left ventricular dP/dt, and mean arterial pressure (MAP). All doses of norepinephrine and the two higher doses of dopamine increased cardiac output, MAP, and peak left ventricular dP/dt during the intoxicated state. Both agents restored all variables to preintoxication values. Values obtained at the highest doses of the two drugs were not different for any variable. Dopamine and norepinephrine each appeared effective in reversing amitriptyline-induced hemodynamic alterations.