What is the appropriate management for a TCA overdose?

The management of a tricyclic antidepressant (TCA) overdose involves several crucial steps, and administering sodium bicarbonate intravenously at a dose of 1 mEq/kg is a well-established treatment approach. This therapy is particularly effective because TCAs can cause cardiotoxicity, which may lead to arrhythmias and a significant increase in serum sodium levels. Sodium bicarbonate helps to alkalinize the serum, which not only counteracts the metabolic acidosis that may arise from the overdose but also stabilizes cardiac membranes, reducing the risk of lethal arrhythmias.

Additionally, sodium bicarbonate can enhance the elimination of the drug from the body by promoting urine alkalinization, thus further reducing the toxic effects associated with the overdose. Given these properties, sodium bicarbonate becomes a first-line treatment in managing the cardiac complications induced by a TCA overdose.