TCA overdose:

 Gives anticholinergic syndrome, So no Atropine

 Cardiac toxicity is the major cause of death
 No correlation between serum level and symptom
A  LOC  RSI
B depression, ARDS
C toxicity,  QT, wide QRS, sinus tach, heart block, hypotension due 
contractility, and vasodilation by -blockade, arrest
CNS hallucination, coma, seizure
M metabolic acidosis
 Management:
o ABC
o Gastric lavage
o Activated charcoal 1g/kg with 60 ml sorbitol
o Bicarb is the Key in the management 2 mEq/kg bolus then infusion
150mEq in 850 D5W to maintain pH 7.45-7.50
o For Vent arrhythmia give Lidocaine, Class 1A,1C are C/I
o Hypotension  Norepi gtt
o Bradycardia Isoprel or pacing No Atropine