When administered, sodium bicarbonate dissociates into a molecule of sodium and bicarbonate. The molecule of bicarbonate in turn binds hydrogen converting into carbonic acid with its subsequent dissociation into carbon dioxide and water.
The benefit of sodium bicarbonate in the setting of TCA overdose is probably due to both an increase in serum pH and the increase in extracellular sodium.
Alkalization favors the neutral form of the drug and reducing the amount of active cyclic antidepressants. The high sodium load increases the electrochemical gradient across cardiac cell membranes, potentially attenuating the TCA-induced blockade of sodium channels.
Hi.. Muhammad,, very interesting question. I totally agreed with Lobna's answer. Sodium bicarbonate correct the metabolic acidosis and There by improves blood pressure. Alkalinisation of blood and urine overcome the drug toxicity by reducing the amount of effective drugs by ion trapping and reducing distribution of drugs.. It also has got effect in sodium channel binding site of drugs.. Thanks
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