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SODIUM BICARBONATE

Class
Description
Onset and Duration
Indications
Contraindications
Adverse Reactions
Drug Interactions
How Supplied
Dosage and Administration
Special Considerations


SODIUM BICARBONATE
Class

Buffer


SODIUM BICARBONATE
Description

Sodium bicarbonate reacts with hydrogen ions to form water and carbon dioxide and thereby can act to buffer metabolic acidosis. Increasing the plasma concentration of bicarbonate causes blood pH to rise.


SODIUM BICARBONATE
Onset & Duration

Onset:
2-10 min
Duration:
30-60 min

SODIUM BICARBONATE
Indications

Known preexisting bicarbonate-responsive acidosis
Intubated patient with continued long arrest interval
Upon return of spontaneous circulation after long arrest interval
Tricyclic antidepressant overdose
Alkalinization for treatment of specific intoxications


SODIUM BICARBONATE
Contraindications

In patients with chloride loss from vomiting and Gl suction
Metabolic and respiratory alkalosis
Hypocalcemia
Hypokalemia


SODIUM BICARBONATE
Adverse Reactions

Metabolic alkalosis
Hypoxia
Rise in intracellular Pco2 and increased tissue acidosis
Electrolyte imbalance (tetany)
Seizures
Tissue slougthing at injection site


SODIUM BICARBONATE
Drug Interactions

May precipitate in calcium solutions.
Alkalinization of urine may increase half-lives of certain drugs.
Vasopressors may be deactivated.


SODIUM BICARBONATE
How Supplied

50 mEq in 50 ml of solvent


SODIUM BICARBONATE
Dosage and Administration

Urgent forms of metakolic acidosis
Adult:
1 mEq/kg IV; repeat with 0.5 mEq/kg q 10 min
Pediatric:
Same as adult

SODIUM BICARBONATE
Special Considerations

Pregnancy safety: Category C.
When possible, blood gas analysis should guide bicarbonate administration.
Bicarbonate administration produces carbon dioxide, which crosses cell membranes more rapidly than bicarbonate, potentially worsening intracellular acidosis.
May increase edematous or sodium-retaining states.
May worsen congestive heart failure.