Tricyclic antidepressant overdose — RCPSC EM MCQ
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Correct answer: B — Give IV sodium bicarbonate and reassess cardiac conduction and systemic perfusion
Explanation lettering: E = shown as A · D = shown as B · B = shown as D · A = shown as E
D is correct for severe TCA sodium-channel blockade. E can worsen conduction and seizures. A adds sodium-channel blockade. B provokes seizures and has no mechanistic benefit. C is ineffective because of high protein binding and distribution volume.
Reference: Ontario Poison Centre, Tricyclic antidepressant overdose approach: https://www.ontariopoisoncentre.ca/siteassets/pdfs/english/tricyclicoverdoseapproach.pdf