Created at 5:28 p.m. Apr, 26, 2025
Author:
roseee
Rationale for change
UW step 2 q 4487
vignette describing TCA overdose, asking next best step? answer is sodium bicarbonate
answer explanation states: "TCA overdose blocks the cardiac fast sodium channels and decreases myocardial conduction velocity, leading to QRS prolongation and risk of ventricular arrhythmia."
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Text
Sodium bicarbonate alleviates the cardiotoxicity associated with TCA overdose by decreasing TCAs ability to bind {{c1::fast-acting Na+ channels}}
Extra
- Tricyclic antidepressant overdose can present with central nervous system, cardiac, and anticholinergic findings
- Sodium bicarbonate is preferred for treating cardiac arrhythmias
- Patients who are refractory to sodium bicarbonate may respond to adjuvant magnesium or lidocaine
- TCAs inhibit fast sodium channels, so we want to stop this by giving bicarbonate, which increases serum pH and extracellular sodium
Lecture Notes
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Missed Questions
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Pathoma
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Boards and Beyond
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First Aid
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Sketchy




Watch Tricyclic Antidepressants




Sketchy 2
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Sketchy Extra
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Picmonic
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Pixorize
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Physeo
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Bootcamp
Watch associated Bootcamp video - Side Effects and Toxins: Pharmacological Toxicity and Treatment
Watch associated Bootcamp video - Pharmacology: Tricyclic Antidepressants
Watch associated Bootcamp video - Pharmacology: Tricyclic Antidepressants
OME
Additional Resources
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