Sodium Bicarbonate

From Anvita Health Wiki

Contents 1 Indications 2 Contraindications 3 Dosage 4 Pharmacokinetics 5 Adverse-effects 6 Drug-interactions 7 Mechanism-of-action 8 More General Terms 9 Additional Terms 10 Internet Database 11 References

Indications

• renal tubular acidosis ( RTA) type 1: 1-2 meq/kg/day
• cocaine-induced ventricular dysrhythmias
• severe acidemia
• hyperkalemia
• symptomatic treatment of dyspepsia, GERD & peptic ulcer disease
• alkalinization of the urine in certain drug intoxications i.e. acetaminophen, Li+

Contraindications

• pregnancy-category :value C
• safety-in-lactation :value ?

Dosage

• oral: 1-6 tabs 1- 4 times/day as needed
• intravenous ( IV) drip:

• mix 3 or 3/12 amps in 1 L of D5W

• 118 meq/L or 135 meq/L

• infuse at 50 mL/ hr

• 1 amp of bicarbonate = 44.5 meq (8.4%).
• Tabs: 650 mg.
• Injection: 4.2% (0.5 meq/L) 10 mL 7.5% (0.9 meq/L) 50 mL vial & 50 mL syringe 8.4% (1 meq/ mL) 50 mL

Pharmacokinetics

• duration of action for GI tract alkalinization is 30-60 minutes, but may be as long as 3 hours when given after meals
• elimination :route kidney

Adverse-effects

• (excessive administration)
• oral adminstration

• gastric distension
• flatulence
• milk-alkali syndrome
• rebound hyperacidity

• systemic effects

• metabolic alkalosis
• seizures
• tetany
• hypocalcemia
• cardiac arrhythmias
• hypokalemia
• hypernatremia
• increased lactate production
• intracranial acidosis*
• cerebral hemorrhage
• edema
• increased affinity of hemoglobin for O2

• extravasation of IV can cause chemical cellulitis

• * No proven clinical consequences [3].

Drug-interactions

• decreased absorption of many medications

Mechanism-of-action

• alkalinization of the blood &/or GI tract

More General Terms

• salt
• metabolic agent (metabolic modifier)

Additional Terms

• bicarbonate/carbonate (Carbicarb)
• HCO3- (bicarbonate)
• Na+

Internet Database

PubChem: 516892

References

1. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
2. Kaiser Permanente Northern California Regional Drug Formulary, 1998
3. Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998

sodium bicarbonate (NaHCO3)