Florida State Paramedic Practice Exam

What is the treatment for TCI overdose?

1. Activated charcoal

2. Flumazenil

3. Sodium Bicarbonate

4. Atropine

The correct answer is: Sodium Bicarbonate

In the context of treating a TCI (tricyclic antidepressant) overdose, the use of sodium bicarbonate is a key intervention due to its ability to counteract the metabolic acidosis that can occur during significant overdose scenarios. TCI overdoses often result in cardiovascular complications, including arrhythmias and hypotension, and sodium bicarbonate can help improve cardiac function by shifting the pH and mitigating the toxic effects on cardiomyocytes. Additionally, sodium bicarbonate aids in the reduction of the drug's effect on the sodium channels, which is particularly important in TCI overdose where there may be sodium channel blockade leading to increased risk of dysrhythmias. By increasing serum bicarbonate levels, the treatment can help normalize the ECG findings often associated with TCI toxicity, such as widening of the QRS complex. In contrast, other treatments listed may not be suitable for TCI overdose management. Activated charcoal can be used in some situations but is typically only effective if administered within an hour of ingestion and may not be useful in cases where the patient may require airway protection. Flumazenil is contraindicated in TCI overdose as it can cause seizures and further complications. Atropine, while useful in cases of bradycardia, does not