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Electrolyte, Alkalinizing Agent
Mechanism of Action
Given IV: Immediately raises blood pH by buffering excess H+ cations. Excess bicarbonate ions are excreted in urine thus making urine less acidic.
- Severe acidosis refractory to hyperventilation
- Tricyclic antidepressant overdose
- Barbituate overdose
- Known hyperkalemia
None in emergency setting
- Not recommended for routine use in cardiac arrest
- Dosage must be specific to prevent metabolic acidosis and is thus weight based
- Severe necrosis if extravasation occurs
- May produce paradoxical acidosis that can depress cerebral and cardiac function
- May cause extracellular alkalosis which may reduce the concetration of ionized calcium, decrease plasma potassium, and induce a left shift of the oxyhemoglobin curve which may inhibit oxygen release to the tissues and induce malignant dysrhythmias
- Will deactivate most catecholamines and vasopressors
- Sodium bicarbonate will form precipitate in conjunction with calcium chloride
Dosage and Route
- 1 mEq/kg IVP/IO repeat at
- 0.5 mEq/kg q 10 mins prn
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