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sodium bicarbonate (NaHCO3)

Indications: - renal tubular acidosis (RTA) type 1: 1-2 meq/kg/day - cocaine-induced ventricular dysrhythmias - severe acidemia - hyperkalemia - symptomatic treatment of dyspepsia, GERD & peptic ulcer disease - alkalinization of the urine in certain drug intoxications - acetaminophen toxicity - lithium toxicity - salicylate toxicity Contraindications: pregnancy-category :value C safety-in-lactation :value ? Dosage: 1) oral: 1-6 tabs 1-4 times/day as needed 2) intravenous (IV) drip: a) mix 3 or 3/12 amps in 1 L of D5W -> 118 meq/L or 135 meq/L b) infuse at 50 mL/hr 1 amp of bicarbonate = 44.5 meq (8.4%). Tabs: 650 mg. Injection: 4.2% (0.5 meq/L) 10 mL 7.5% (0.9 meq/L) 50 mL vial & 50 mL syringe 8.4% (1 meq/mL) 50 mL Pharmacokinetics: 1) duration of action for GI tract alkalinization is 30-60 minutes, but may be as long as 3 hours when given after meals 2) elimination :route kidney Adverse effects: (excessive administration) 1) oral administration a) gastric distension b) flatulence c) milk-alkali syndrome d) rebound hyperacidity 2) systemic effects a) metabolic alkalosis b) seizures c) tetany d) hypocalcemia e) cardiac arrhythmias f) hypokalemia g) hypernatremia h) increased lactate production i) intracranial acidosis* j) cerebral hemorrhage k) edema l) increased affinity of hemoglobin for O2 3) extravasation of IV can cause chemical cellulitis * No proven clinical consequences [3]. Drug interactions: decreased absorption of many medications Mechanism of action: alkalinization of the blood &/or GI tract

Related

bicarbonate/carbonate (Carbicarb) HCO3- (bicarbonate) Na+

General

salt metabolic agent (metabolic modifier)

Database Correlations

PUBCHEM cid=516892

References

  1. Drug Information & Medication Formulary, Veterans Affairs, Central California Health Care System, 1st ed., Ravnan et al eds, 1998
  2. Kaiser Permanente Northern California Regional Drug Formulary, 1998
  3. Medical Knowledge Self Assessment Program (MKSAP) 11, American College of Physicians, Philadelphia 1998
  4. Deprecated Reference

Component-of

aspirin/citrate/sodium bicarbonate aspirin/citric acid/sodium bicarbonate (Alka-Seltzer) bisacodyl/polyethylene glycol/potassium chloride/sodium bicarbonate/sodium chloride calcium carbonate/potassium bicarbonate/sodium bicarbonate calcium carbonate/sodium bicarbonate calcium chloride/glucose/magnesium chloride/potassium chloride/sodium bicarbonate/sodium chloride/sodium phosphate calcium chloride/glucose/magnesium sulfate/potassium chloride/sodium bicarbonate/sodium chloride/sodium phosphate citrate/potassium bicarbonate/sodium bicarbonate citrate/simethicone/sodium bicarbonate citrate/sodium bicarbonate Elliotts B Solution (buffered intrathecal electrolyte/dextrose injection) hco3 /polyethylene glycol/potassium chloride/sodium bicarbonate/sodium chloride/sodium sulfate magnesium carbonate/sodium bicarbonate magnesium chloride/sodium bicarbonate/sodium chloride magnesium hydroxide/omeprazole/sodium bicarbonate magnesium sulfate/polyethylene glycol/potassium chloride/sodium bicarbonate/sodium chloride omeprazole/sodium bicarbonate pancreatin/potassium bicarbonate/sodium bicarbonate polyethylene glycol/potassium chloride/sodium bicarbonate/sodium chloride potassium bitartrate/sodium bicarbonate sodium bicarbonate/sodium chloride sodium bicarbonate/sodium chloride/sodium phosphate sodium bicarbonate/tartaric acid