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Aspiration of nortriptyline

D R Johnson¹, D Yew

¹Department of Emergency Medicine, University of New Mexico, School of Medicine, Albuquerque.

The American Journal of Emergency Medicine

|May 1, 1994

Summary

Unintentional aspiration of a nortriptyline capsule caused severe respiratory distress in a young woman. Prompt bronchoscopy revealed significant airway inflammation and edema, highlighting a rare but serious complication.

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Area of Science:

Pharmacology
Pulmonology
Critical Care Medicine

Background:

Unintentional aspiration of medication is uncommon.
Nortriptyline is a tricyclic antidepressant used for various conditions.
Neurological impairment can increase aspiration risk.

Observation:

A 23-year-old neurologically impaired woman unintentionally aspirated a 50-mg nortriptyline capsule.
The patient developed progressive respiratory distress requiring mechanical ventilation.
Bronchoscopic examination was performed to assess airway status.

Findings:

Bronchoscopy revealed severe inflammation and edema of the airways.
The aspirated capsule was likely the direct cause of the respiratory compromise.
The case highlights a rare adverse event associated with oral medication administration.

Implications:

This case underscores the potential for serious respiratory complications from foreign body aspiration, even with medication capsules.
Clinicians should be aware of aspiration risks in patients with neurological deficits.
Early diagnostic procedures like bronchoscopy are crucial for managing such critical airway events.

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