Indications
Sodium Bicarbonate is indicated in- 1. Management of acidosis in cardiac arrest. 2. Alkalinization of urine. 3. Management of metabolic acidosis in: Severe renal disease Uncontrolled diabetes Circulatory insufficiency from shock or dehydration Severe primary lactic acidosis
Composition
Pharmacology
Sodium bicarbonate is a systemic alkalizer, which increases plasma bicarbonate, buffers excess hydrogen ion concentration, and raises blood pH, thereby reversing the clinical manifestations of acidosis. It is also a urinary alkalizer, increasing the excretion of free bicarbonate ions in the urine, thus effectively raising the urinary pH. It also replenishes electrolyte imbalance in severe diarrhea where the loss of bicarbonate can be significant.
Dosage & Administration
Oral : The usual dose is 300 mg to 2 grams, 1 to 4 times daily. Intravenous (Severe metabolic acidosis): Adult: By slow inj of a hypertonic solution of up to 8.4% (1000 mmol/L), or by continuous infusion of a weaker solution, usually 1.26% (150 mmol/L). For correction of acidosis during advanced cardiac life support procedures, 50 ml of an 8.4% solution may be given. Elderly: Dosage adjustments may be required.
Contraindications
This drug is contraindicated in hypersensitivity hypoventilatory states, excessive chloride depletion owing to continuous gastric fluid loss from vomiting or GI suctioning, metabolic and/or respiratory alkalosis, hypocalcemia and diuretics known to produce hypochloremic alkalosis.
Side Effects
Common side effects: Headache Nausea Irritability Notify your doctor you develop any of the following effects: Muscle weakness Slow reflexes Confusion Swelling of the feet or ankles Black tar-like stools Coffee-ground vomit
Pregnancy & Lactation
Use during pregnancy only if the potential benefit justifies the potential risk to the fetus. Pregnant women: Based on animal data showing adverse renal effects, it is not recommended during the second and third trimesters of pregnancy. It may worsen high blood pressure. This medication may pass into breast milk.
Precautions & Warnings
Caution should be taken for patients with pre-existing heart disease, kidney disease, liver disease, high blood pressure, any allergies because this medication contains salt (sodium), do not use it if you are on a salt restricted diet.
Therapeutic Class
Intravenous fluid preparations, Urinary Alkalinizing Agent
Storage Conditions
Do not store above 30°C, protect from light & moisture. Keep the medicine out of reach of children.