Sodium Bicarbonate 8.4%
Class:
Buffer, alkalinizer.
Buffer, alkalinizer.
Mechanism of Action:
Reacts with hydrogen ions to form water and carbon dioxide thereby acting as a buffer for metabolic acidosis.
Reacts with hydrogen ions to form water and carbon dioxide thereby acting as a buffer for metabolic acidosis.
Indications:
- Hyperkalemia
- TCA overdose
- Phenobarbital overdose
- Known pre-existing bicarbonate-responsive acidosis.
- Upon return of spontaneous circulation after long arrest interval.
- Alkalinization for treatment of specific intoxications.
Contraindications:
- Metabolic and respiratory alkalosis.
- Hypocalcemia and hypokalemia.
- Hypocloremia secondary to GI loss and vomiting.
Adverse reactions:
- Metabolic alkalosis, hypokalemia, hyperosmolarity, fluid overload.
- Increase in tissue acidosis.
- Electrolyte imbalance and tetany, seizures.
- Tissue sloughing at injection site.
Drug Interactions
- May precipitate in Calcium solutions.
- Vasopressors may be deactivated.
Adult Dosage and Administration
1 mEq / kg IV; may repeat with 0.5 mEq / kg every 10 minutes.
1 mEq / kg IV; may repeat with 0.5 mEq / kg every 10 minutes.
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Pediatric Dosage and Administration:Same as for adult.
Duration of Action
- Onset: 2-10 minutes.
- Peak effect: 15-20 minutes.
- Duration: 30-60 minutes.
Special Considerations:
- Pregnancy safety: Category C.
- Must ventilate patient after administration.
- Intracellular acidosis may be worsened by production of carbon dioxide.
- May worsen CHF (congestive heart failure).