Key result
High-dose glucagon increases mean arterial pressure and shortens prolonged QRS in amitriptyline-toxic rats.
Why the study?
The effect of glucagon on cardiovascular parameters in tricyclic antidepressant overdose was not well understood.
Does glucagon improve cardiovascular parameters in a rat model of amitriptyline-induced toxicity?
RCT
randomized
Does glucagon improve cardiovascular parameters in a rat model of amitriptyline-induced toxicity?
p-value: p=<0.05
In a rat model of amitriptyline toxicity, a high-dose glucagon bolus followed by continuous infusion effectively reversed hypotension and QRS prolongation.
Glucagon reversed amitriptyline-induced hypotension and QRS prolongation in rats; leaves open any role in human TCA overdose pending clinical data.
The aim of this study was to investigate the effect of glucagon on cardiovascular parameters in anesthetized rat model of tricyclic antidepressant overdose. Toxicity was induced by infusion of amitriptyline 0.94 mg/kg/min until a 40-45% of reduction in mean arterial pressure was observed. Amitriptyline infusion rats were then randomized into three groups. Control group of rats (group 1) received a bolus of 5% dextrose followed by the continuous infusion of dextrose, whereas treatment groups received 1 mg/kg (group 2) or 2 mg/kg (group 3) bolus doses of glucagon followed by continuous infusion (0.1 mg/kg/min) of glucagons for 60 min. Mean arterial pressure, heart rate, and electrocardiogram were recorded. Amitriptyline caused a significant decrease in mean arterial pressure and a prolongation in QRS, yet it did not change the heart rate. High-bolus dose of glucagon (2 mg/kg) followed by glucagon infusion significantly increased mean arterial pressure at 40, 50, and 60 min (P < 0.05) and shortened the prolonged QRS at 50 and 60 min (P < 0.05) when compared with control group. There was also a significant increase in heart rate. In conclusion, bolus doses followed by a continuous infusion of glucagon were found to be effective in reversing the hypotension and QRS prolongation in the rat model of amitriptyline toxicity. Further studies are needed to reveal the exact mechanism of the proposed effect.
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Kaplan et al. (2008) conducted an RCT in amitriptyline-induced cardiovascular toxicity. Glucagon vs. 5% dextrose bolus and continuous infusion was evaluated on mean arterial pressure and QRS duration (p=<0.05). A high-bolus dose of glucagon (2 mg/kg) followed by continuous infusion significantly increased mean arterial pressure and shortened prolonged QRS in a rat model of amitriptyline toxicity (P<0.05).
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