This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Psychiatry
A young female on antidepressants presents to the emergency with altered sensorium and hypotension. ECG reveals wide QRS complexes and right axis detion. Next best step for the management of this patient: 
Select and explain. 
A. Sodium bicarbonate, B. Hemodialysis, C. Fomepizole, D. Flumazenil
A: Sodium bicarbonate
Answer: A: Sodium bicarbonate 
Explanation: Ans: A. Sodium bicarbonate(Ref Harrison 19/e p172)Typically suggest a diagnosis of tricyclic antidepressant poisoning.Antidote for TCA poisoning - Sodium bicarbonate.Administered IV 100 mEq (1-2 mEq/kg), and repeated every few minutes until BP improves and QRS complexes begin to narrow.Hemodialysis should not be used since TCAs are highly protein-bound with large volume of distribution.