Step I TCA OD Treatment

[motiv55555]

First Aid says that TCA's are an example of a weak base and in order to trap weak bases in the urine you need to acidify the environment with something like ammonium chloride. I'm just wondering why First Aid then later says to treat TCA overdose with sodium bicarbonate (something that would be used to trap weak acids in the urine by alkalinizing it). Thanks in advance for the input!

 

[ScrubsLover9319]

First Aid says that TCA's are an example of a weak base and in order to trap weak bases in the urine you need to acidify the environment with something like ammonium chloride. I'm just wondering why First Aid then later says to treat TCA overdose with sodium bicarbonate (something that would be used to trap weak acids in the urine by alkalinizing it). Thanks in advance for the input!

I'm pretty sure the reason is because you're more worried about the TCA OD blocking the sodium channels in the heart and leading to an arrhythmia so you'd want to focus on preventing the deadliest event which would be that in this case. So we use NaHCO3 to keep the heart's sodium channels working properly.

 

[motiv55555]

I'm pretty sure the reason is because you're more worried about the TCA OD blocking the sodium channels in the heart and leading to an arrhythmia so you'd want to focus on preventing the deadliest event which would be that in this case. So we use NaHCO3 to keep the heart's sodium channels working properly.

Thanks!

 

[iBS1972]

Scrub's response is correct.
Keep in mind though that NaBicarb is also used as an antidote for aspirin (salicylic ACID) toxicity, and the mechanism for that IS by alkalizing the urine.