Class
Description
Onset and Duration
Indications
Contraindications
Adverse Reactions
Drug Interactions
How Supplied
Dosage and Administration
Special Considerations
Buffer
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.
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
In patients with chloride loss from vomiting and Gl suction
Metabolic and respiratory alkalosis
Hypocalcemia
Hypokalemia
Metabolic alkalosis
Hypoxia
Rise in intracellular Pco2 and increased tissue acidosis
Electrolyte imbalance (tetany)
Seizures
Tissue slougthing at injection site
May precipitate in calcium solutions.
Alkalinization of urine may increase half-lives of certain drugs.
Vasopressors may be deactivated.
50 mEq in 50 ml of solvent
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.