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Sodium Bicarbonate

Sodium Bicarbonate 8.4% and 4.2%

CLASS

Buffer, Alkalinizing agent, Antacid

DOSAGE

    Adult: 1 mEg/kg IV (8.4%). Repeat with 0.5 mEq/kg q 10 minutes.

    Pediatric: 1 mEg/kg IV (8.4%). Repeat with 0.5 mEq/kq q 10 minutes.

    Infant: 1 mEq/kg IV (4.2%) slowly. May repeat in 10 minutes.

ACTIONS

    An alkalizing agent used to buffer acids present in the body during and after severe hypoxia. Bicarbonate combines with excess acids (usually lactic acid) present in the body to form a weak, volatile acid. This acid is broken down into CO2 and H2O. Sodiumbicarbonate is effective only when administered with adequate ventilation and oxygenation.

INDICATIONS

    Metabolic acidosis due to:
      - Salicylate (Aspirin) overdose.
      - Barbiturate overdose.
      - Tricyclic antidepressant overdose.
      - Hyperkalemia.
      - Severe ketoacidosis.
      - Cardiac arrest.
      - Shock.
      - Physostigmine toxicity.
      - Methanol toxicity.
      - Ethylene glycol toxicity.

    CONTRAINDICATIONS

      Congestive heart failure; alkalotic states.

    WARNINGS

      Excessive bicarbonate therapy inhibits the release of oxygen. Bicarbonate does not improve the ability to defibrillate. May inactivate simultaneously if administered with catecholamines. Will precipitate if mixed with calcium chloride. Administration should be guided by arterial blood gasses and ph, when available.

    SIDE EFFECTS

      Metabolic alkalosis, hypernatremia, cerebral acidosis, sodium and H2O retention, which can cause CHF.

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