{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T13:22:53Z","timestamp":1776086573066,"version":"3.50.1"},"reference-count":30,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2025,5,24]],"date-time":"2025-05-24T00:00:00Z","timestamp":1748044800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,5,24]],"date-time":"2025-05-24T00:00:00Z","timestamp":1748044800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Sage Open Medical Case Reports"],"published-print":{"date-parts":[[2025,12]]},"abstract":"<jats:p>Elderly patients are particularly vulnerable to look-alike\/sound-alike medication errors due to physiological differences that alter medication pharmacokinetics and pharmacodynamics. This report presents the case of a 70-year-old woman admitted to the emergency department in an unconscious state. The information provided by the patient\u2019s family suggested a potential unintentional amitriptyline overdose due to confusion with berberine\u2014a plant-derived over-the-counter antidiarrheal medication of similar appearance and packaging. Examination of the remaining amitriptyline tablets indicated the patient had likely consumed 19 tablets of 25 mg amitriptyline. This suspicion was supported by an electrocardiogram showing QRS widening to 110 ms and tachycardia. Following serum alkalization therapy with sodium bicarbonate, the patient\u2019s consciousness improved, her heart rate normalized, and QRS duration was shortened. This case underscores the importance of involving healthcare providers and family members in implementing robust safety measures to prevent unintentional medication errors caused by look-alike\/sound-alike medications, particularly among older adults.<\/jats:p>","DOI":"10.1177\/2050313x251344032","type":"journal-article","created":{"date-parts":[[2025,5,25]],"date-time":"2025-05-25T02:16:54Z","timestamp":1748139414000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Unintentional amitriptyline overdose leading to coma and cardiac conduction impairment in an older adult: A case report"],"prefix":"10.1177","volume":"13","author":[{"given":"Hau Viet","family":"Nguyen","sequence":"first","affiliation":[{"name":"Emergency Department, University Medical Center Ho Chi Minh City, Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kiet Anh","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Emergency Department, University Medical Center Ho Chi Minh City, Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ngan Kim","family":"Dang","sequence":"additional","affiliation":[{"name":"Emergency Department, University Medical Center Ho Chi Minh City, Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lana","family":"Rinchen","sequence":"additional","affiliation":[{"name":"Pharmacy Department, Flinders Medical Center, Bedford Park, SA, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2805-541X","authenticated-orcid":false,"given":"Trang Thi","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Pharmacy Department, University Medical Center Ho Chi Minh City, Vietnam"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,5,24]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph18115948"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2015.8581"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40266-016-0408-8"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1080\/14656566.2021.1947241"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(74)91639-0"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1159\/000495363"},{"issue":"15","key":"e_1_3_3_8_2","first-page":"508","article-title":"Acute onset of impaired consciousness: diagnostic evaluation in the emergency department","volume":"121","author":"Weiglein T","year":"2024","unstructured":"Weiglein T, Zimmermann M, Niesen W-D, et al. Acute onset of impaired consciousness: diagnostic evaluation in the emergency department. Dtsch Arztebl Int 2024; 121(15): 508.","journal-title":"Dtsch Arztebl Int"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0307540"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.7861\/clinmedicine.18-1-88"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2015-211428"},{"key":"e_1_3_3_12_2","volume-title":"Goldfrank\u2019s toxicologic emergencies","author":"Valento M","year":"2019","unstructured":"Valento M, Liebelt EL. Cyclic antidepressants. In: Nelson LS, Howland MA, Lewin NA, et al. (eds.) Goldfrank\u2019s toxicologic emergencies. 11th ed. McGraw-Hill Education, 2019: 6490.","edition":"11"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.4103\/0971-6580.103682"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.2165\/00139709-200524030-00013"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.1136\/emj.2010.091553"},{"key":"e_1_3_3_16_2","doi-asserted-by":"publisher","DOI":"10.1136\/bcr-2016-214685"},{"key":"e_1_3_3_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(95)70151-6"},{"key":"e_1_3_3_18_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM198508223130804"},{"key":"e_1_3_3_19_2","doi-asserted-by":"publisher","DOI":"10.1177\/0310057X7300100302"},{"key":"e_1_3_3_20_2","doi-asserted-by":"publisher","DOI":"10.1080\/15563650701517491"},{"key":"e_1_3_3_21_2","first-page":"702","article-title":"Present status of acute medication intoxication in elderly","volume":"26","author":"Sugimura T","year":"2015","unstructured":"Sugimura T, Muraishi M, Ariyoshi K. Present status of acute medication intoxication in elderly. JJAAM 2015; 26: 702\u2013706.","journal-title":"JJAAM"},{"key":"e_1_3_3_22_2","doi-asserted-by":"publisher","DOI":"10.1177\/1756284820961299"},{"key":"e_1_3_3_23_2","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.14285"},{"key":"e_1_3_3_24_2","doi-asserted-by":"publisher","DOI":"10.1111\/bcp.14644"},{"key":"e_1_3_3_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.sapharm.2015.07.002"},{"key":"e_1_3_3_26_2","doi-asserted-by":"publisher","DOI":"10.1186\/s12877-019-1102-6"},{"key":"e_1_3_3_27_2","doi-asserted-by":"publisher","DOI":"10.4140\/TCP.n.2017.269"},{"issue":"11","key":"e_1_3_3_28_2","first-page":"1","article-title":"Adopt strategies to manage look-alike and\/or sound-alike medication name mix-ups","volume":"27","author":"Institute for Safe Medication Practices","year":"2022","unstructured":"Institute for Safe Medication Practices. Adopt strategies to manage look-alike and\/or sound-alike medication name mix-ups. ISMP Med Saf Alert Acute Care Ed 2022; 27(11): 1\u20134.","journal-title":"ISMP Med Saf Alert Acute Care Ed"},{"key":"e_1_3_3_29_2","unstructured":"World Health Organization. Medication safety for look-alike sound-alike medicines https:\/\/www.who.int\/publications\/i\/item\/9789240058897 (accessed 11 December 2024)."},{"key":"e_1_3_3_30_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cll.2025.01.003"},{"key":"e_1_3_3_31_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(18)30458-6"}],"container-title":["Sage Open Medical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2050313X251344032","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/2050313X251344032","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/2050313X251344032","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,6]],"date-time":"2026-01-06T05:19:29Z","timestamp":1767676769000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/2050313X251344032"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,24]]},"references-count":30,"alternative-id":["10.1177\/2050313X251344032"],"URL":"https:\/\/doi.org\/10.1177\/2050313x251344032","relation":{},"ISSN":["2050-313X","2050-313X"],"issn-type":[{"value":"2050-313X","type":"print"},{"value":"2050-313X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5,24]]},"article-number":"2050313X251344032"}}