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Sodium Bicarbonate 8.4%
Trade Name
Sodium Bicarb
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Sodium Bicarbonate 8.4%
Class
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Sodium Bicarbonate 8.4%
Mechanism of Action
Reacts with hydrogen ions to form water and carbon dioxide thereby acting as a buffer for metabolic acidosis
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Sodium Bicarbonate 8.4%
Indications
- Known pre-existing bicarbonate-responsive acidosis
- Upon return of spontaneous circulation after long arrest interval
- TCA overdose
- Hyperkalemia
- Phenobarbital overdose
- Alkalinization for treatment of specific intoxications
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Sodium Bicarbonate 8.4%
Contraindications
- Metabolic and respiratory alkalosis
- Hypocalcemia and hypokalemia
- Hypocloremia secondary to GI loss and vomiting
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Sodium Bicarbonate 8.4%
Adverse Reactions
- Metabolic alkalosis
- Hypokalemia
- Hyperosmolarity
- Fluid overload
- Increase in tissue acidosis
- Electrolyte imbalance
- Tetany
- Seizures
- Tissue sloughing at injection site
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Sodium Bicarbonate 8.4%
Drug Interactions
- May precipitate in calcium solutions
- Half-lives of certain drugs may increase through alkalinization of the urine
- Vasopressors may be deactivated
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Sodium Bicarbonate 8.4%
How Supplied
50 mEq in 50 ml of solvent
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Sodium Bicarbonate 8.4%
Dosage and Administration
Adult
- 1 mEq/kg IV; may repeat with 0.5 mEq/kg every 10 minutes
- Infusion: 1 to 4 amps in 1 liter D5W or NS, rate determined by sending physician
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Sodium Bicarbonate 8.4%
Dosage and Administration
Pediatric
- Same as for adult
- Infusion: Same as for adult
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Sodium Bicarbonate 8.4%
Duration of Action
- Onset: 2-10 minutes
- Peak effect: 15-20 minutes
- Duration: 30-60 minutes
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Sodium Bicarbonate 8.4%
Special Considerations
- Pregnancy safety: Category C
- Must ventilate patient after administration
- Whenever possible, blood gas analysis should guide use of bicarbonate
- Intracellular acidosis may be worsened by production of carbon dioxide
- May increase edematous states
- May worsen CHF
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