the real reason for alkalinizing the urine?

[amestramgram]

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Hi, I was told that drug overdoses via TCA should be treated with NaHCO3 to get the urine alkalinized, to help excrete the drug faster. However, USMLE World tells me that the reason NaHCO3 is used is to competitively inhibit the binding of the TCA molecules to the sodium channel. Which is the right info that I need to learn for the exam?

thanks for your help

 

[SmokD]

TCA's block Na channels in the heart.You give NaHCO3 to provide the sodium to overcome the Na block. Giving Sodium Bicarb will have no effect on urine pH. To alkalinize the urine you give Acetazolamide(carbonic anhydrase inhibitor)

EDIT: Just to clarify, NaCO3 does NOT competitively inhibit the binding of TCA molecules to the sodium channels.