Tricyclic antidepressant overdose with sodium-channel blockade — SCE Acute Medicine MCQ
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ModerateToxicology and OverdoseTricyclic antidepressant overdose with sodium-channel blockadeSCE Acute Medicine
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Correct answer: B — Give intravenous sodium bicarbonate
TCA overdose with hypotension, broad QRS and ventricular arrhythmia is treated with IV sodium bicarbonate to overcome sodium-channel blockade. Amiodarone and beta-blockade may worsen conduction and hypotension. Flumazenil does not treat TCA toxicity and may provoke seizures if mixed overdose is present. The ECG QRS duration is a key severity marker.
Reference: TOXBASE tricyclic antidepressant poisoning, BNF