sodium_bicarbonate.txt

Sodium Bicarb

• Buffer
• Alkalinizer

Reacts with hydrogen ions to form water and carbon dioxide thereby acting as a buffer for metabolic acidosis

• 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

• Metabolic and respiratory alkalosis
• Hypocalcemia and hypokalemia
• Hypocloremia secondary to GI loss and vomiting

• Metabolic alkalosis
• Hypokalemia
• Hyperosmolarity
• Fluid overload
• Increase in tissue acidosis
• Electrolyte imbalance
• Tetany
• Seizures
• Tissue sloughing at injection site

• May precipitate in calcium solutions
• Half-lives of certain drugs may increase through alkalinization of the urine
• Vasopressors may be deactivated

50 mEq in 50 ml of solvent

• 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

• Same as for adult
• Infusion: Same as for adult

• Onset: 2-10 minutes
• Peak effect: 15-20 minutes
• Duration: 30-60 minutes

• 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