MED-Sodium Bicarbonate

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MED-Sodium Bicarbonate
2010-07-10 16:14:55
MED Sodium Bicarbonate

MED-Sodium Bicarbonate
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  1. Functional Class
    Electrolyte, Alkalinizing Agent
  2. 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.
  3. Indications
    • Severe acidosis refractory to hyperventilation
    • Tricyclic antidepressant overdose
    • Barbituate overdose
    • Known hyperkalemia
  4. Contraindications
    None in emergency setting
  5. Precautions
    • Not recommended for routine use in cardiac arrest
    • Dosage must be specific to prevent metabolic acidosis and is thus weight based
  6. Side Effects
    • 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
  7. Interactions
    • Will deactivate most catecholamines and vasopressors
    • Sodium bicarbonate will form precipitate in conjunction with calcium chloride
  8. Dosage and Route
    • 1 mEq/kg IVP/IO repeat at
    • 0.5 mEq/kg q 10 mins prn