Which overdose does Sodium Bicarbonate help treat?

Sodium bicarbonate is particularly useful in treating tricyclic antidepressant (TCA) overdoses, primarily due to its ability to counteract the cardiotoxic effects associated with this type of poisoning. TCAs can lead to metabolic acidosis, life-threatening arrhythmias, and sodium channel blockade, which can result in significant cardiovascular complications, including widening of the QRS complex on an electrocardiogram.

The alkalizing effect of sodium bicarbonate can help to stabilize cardiac function, correct metabolic acidosis, and even reverse some of the sodium channel blockade caused by TCAs. By shifting the pH, it can effectively counteract these dangerous effects and improve the overall prognosis in cases of TCA overdose.

This therapeutic approach is not applicable to the other listed overdoses. For instance, while opiate and benzodiazepine overdoses often require supportive care and the use of specific antidotes like naloxone or flumazenil, sodium bicarbonate does not significantly affect their mechanisms of toxicity. Barbiturate overdose management similarly focuses on supportive care and does not prominently involve the use of sodium bicarbonate. Thus, the unique properties of sodium bicarbonate in addressing the complications of TCA overdose make it the correct choice here.