Florida State Paramedic Practice Exam

Which medication is used as an antidote for tricyclic antidepressant overdose?

1. Activated charcoal

2. Sodium bicarb

3. Atropine

4. Flumazenil

The correct answer is: Sodium bicarb

Sodium bicarbonate is the medication used as an antidote for tricyclic antidepressant (TCA) overdose primarily due to its ability to help address the cardiotoxic effects associated with such overdoses. TCAs can cause significant arrhythmias and other cardiac complications, primarily because of the sodium channel blockade they induce. Administering sodium bicarbonate enhances the sodium level in the extracellular fluid, which can help to reverse the cardiac toxicity by effectively counteracting the sodium channel blockage. Activated charcoal, while useful for limiting the absorption of ingested toxins, is not a specific antidote and its effectiveness diminishes once significant time has elapsed since ingestion. Atropine may be utilized in certain situations of bradycardia due to TCA toxicity but does not directly serve as an antidote. Flumazenil is an antidote for benzodiazepine overdoses and is not applicable to TCA overdoses. Thus, sodium bicarbonate stands out as the correct choice for this scenario due to its direct impact on the physiological complications arising from TCA toxicity.