sodium bicarbonate

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sodium

 [so´de-um]
a chemical element, atomic number 11, atomic weight 22.990, symbol Na. (See Appendix 6.) Sodium is the major cation of the extracellular fluid, constituting 90 to 95 per cent of all cations in the blood plasma and interstitial fluid; it thus determines the osmolality of the extracellular fluid. The serum sodium concentration is normally about 140 mEq/L. If the sodium level and osmolality fall, osmoreceptors in the hypothalamus are stimulated and cause the release of antidiuretic hormone from the posterior lobe of the pituitary gland. This hormone increases the absorption of water in the collecting ducts of the kidneys so that water is conserved while sodium and other electrolytes are excreted in the urine. If the sodium level and osmolality rise, neurons in the thirst center of the hypothalamus are stimulated. The thirsty person then drinks enough water to restore the osmolality of the extracellular fluid to the normal level.



A decrease in the serum sodium concentration (hyponatremia) can occur in a variety of conditions. It is often associated with deficient fluid volume due to diarrhea or vomiting when water is replaced faster than sodium. It can also occur in syndrome of inappropriate antidiuretic hormone, in the late stages of congestive heart failure or cirrhosis of the liver, in acute or chronic renal failure, and in diuretic therapy. An increase in the serum sodium concentration (hypernatremia) occurs when insensible water loss is not replaced by drinking, as in a comatose patient with diabetes insipidus.
sodium acetate a source of sodium ions for hemodialysis and peritoneal dialysis, as well as a systemic and urinary alkalizer.
sodium ascorbate an antiscorbutic vitamin and nutritional supplement for parenteral administration. It is also used as an aid to deferoxamine therapy in the treatment of chronic iron toxicity.
sodium benzoate an antifungal agent also used in a test of liver function.
sodium bicarbonate NaHCO3, a white powder commonly found in households. It has a wide variety of uses in chemistry, in pharmaceuticals, and in consumer products. It is sometimes taken in water as a remedy for acid indigestion but should not be used regularly since when taken in excess it tends to cause alkalosis. It can be mixed with water and applied as a paste for relief of pain in treatment of minor burns and insect bites and stings. A cupful in the bath water may help relieve itching caused by an allergic reaction. Called also baking soda and bicarbonate of soda.
sodium biphosphate monobasic sodium phosphate.
sodium carbonate a compound now used primarily as an alkalizing agent in pharmaceuticals; it has been used as a lotion or bath in the treatment of scaly skin, and as a detergent.
sodium chloride common table salt, a necessary constituent of the body and therefore of the diet, involved in maintaining osmotic tension of blood and tissues; uses include replenishment of electrolytes in the body, irrigation of wounds and body cavities, enema, inhaled mucolytic, topical osmotic ophthalmic agent, and preparation of pharmaceuticals. Called also salt.
sodium citrate a sodium salt of citric acid, used as an anticoagulant for blood or plasma that is to be fractionated or for blood that is to be stored. It is also administered orally as a urinary alkalizer.
dibasic sodium phosphate a salt of phosphoric acid; used alone or in combination with other phosphate compounds, it is given intravenously as an electrolyte replenisher, orally or rectally as a laxative, and orally as a urinary acidifier and for prevention of kidney stones.
sodium ferric gluconate a hematinic used especially in treatment of hemodialysis patients with iron deficiency anemia who are also receiving erythropoietin therapy. Administered by intravenous injection.
sodium fluoride a dental caries preventative used in fluoridation of drinking water or applied topically to teeth. Topical preparations include gels (sodium fluoride and phosphoric acid gel, also called APF gel) and solutions (sodium fluoride and acidulated phosphate topical solution, also called APF solution).
sodium glutamate monosodium glutamate.
sodium hydroxide NaOH, a strongly alkaline and caustic compound; used as an alkalizing agent in pharmaceuticals.
sodium hypochlorite a compound having germicidal, deodorizing, and bleaching properties; used in solution to disinfect utensils, and in diluted form (Dakin's solution) as a local antibacterial.
sodium iodide a compound used as a source of iodine.
sodium lactate a compound used in solution to replenish body fluids and electrolytes.
monobasic sodium phosphate
1. a monosodium salt of phosphoric acid; used in buffer solutions, as a urinary acidifier, as a laxative, and as a source of phosphorus in hypophosphatemia, often in combination with potassium phosphate.
2. a monosodium salt of phosphoric acid; used in buffer solutions. Used alone or in combination with other phosphate compounds, it is given intravenously as an electrolyte replenisher, orally or rectally as a laxative, and orally as a urinary acidifier and for prevention of kidney stones.
sodium monofluorophosphate a dental caries preventative applied topically to the teeth.
sodium nitrite an antidote for cyanide poisoning; also used as a preservative in cured meats and other foods.
sodium nitroprusside an antihypertensive agent used in the treatment of acute congestive heart failure and of hypertensive crisis and to produce controlled hypotension during surgery; also used as a reagent.
sodium phenylbutyrate an agent used as adjunctive treatment to control the hyperammonemia of pediatric urea cycle enzyme disorders.
sodium phosphate any of various compounds of sodium and phosphoric acid; usually specifically dibasic sodium phosphate.
sodium polystyrene sulfonate an ion-exchange resin used for removal of potassium ions in hyperkalemia, administered orally or rectally.
sodium propionate a salt used as an antifungal preservative in foods and pharmaceuticals and as a topical antifungal agent.
sodium salicylate see salicylate.
sodium sulfate a cathartic and laxative.
sodium thiosulfate a compound used intravenously as an antidote for cyanide poisoning, in foot baths for prophylaxis of ringworm, and as a topical antifungal agent for tinea versicolor. Also used in measuring the volume of extracellular body fluid and the renal glomerular filtration rate.

sodium bicarbonate

Arm & Hammer Baking Soda, Bell/ans, Citrocarbonate, Naturalyte (CA)

Pharmacologic class: Fluid and electrolyte agent

Therapeutic class: Alkalinizer, antacid

Pregnancy risk category C

Action

Restores body's buffering capacity; neutralizes excess acid

Availability

Injection: 4% (2.4 mEq/5 ml), 4.2% (5 mEq/10 ml), 5% (297.5 mEq/500 ml), 7.5% (8.92 mEq/10 ml and 44.6 mEq/50 ml), 8.4% (10 mEq/10 ml and 50 mEq/50 ml)

Oral solution (Citrocarbonate): sodium 30.46 mEq/3.9 g and sodium citrate 1.82 g/3.9 g

Tablets: 325 mg, 650 mg

Indications and dosages

Metabolic acidosis

Adults and children: 2 to 5 mEq/kg by I.V. infusion over 4 to 8 hours. However, dosage highly individualized based on patient's condition and blood pH and carbon dioxide content.

Urinary alkalization

Adults: Initially, 4 g P.O.; then 1 to 2 g P.O. q 4 hours

Children: 1 to 10 mEq/kg/day P.O. in divided doses given q 4 to 6 hours

Renal tubular acidosis

Adults: For distal tubular acidosis, 0.5 to 2 mEq/kg P.O. daily in four to five equal doses. For proximal tubular acidosis, 4 to 10 mEq/kg P.O. daily in divided doses.

Antacid

Adults: 300 mg to 2 g P.O. up to q.i.d., given with a glass of water

Contraindications

• Hypocalcemia
• Metabolic or respiratory alkalosis
• Hypernatremia
• Hypokalemia
• Severe pulmonary edema
• Seizures
• Vomiting resulting in chloride loss
• Diuretic use resulting in hypochloremic alkalosis
• Acute ingestion of mineral acids (with oral form)

Precautions

Use cautiously in:
• renal insufficiency, heart failure, hypertension, peptic ulcer, cirrhosis, toxemia
• pregnant patients.

Administration

• For I.V. use, infuse at prescribed rate using controlled infusion device.

Don't give concurrently with calcium or catecholamines (such as norepinephrine, dobutamine, dopamine). If patient is receiving sodium bicarbonate with any of these drugs, flush I.V. line thoroughly after each dose to prevent contact between drugs.

Adverse reactions

CNS: headache, irritability, confusion, stimulation, tremors, twitching, hyperreflexia, weakness, seizures of alkalosis, tetany

CV: irregular pulse, edema, cardiac arrest

GI: gastric distention, belching, flatulence, acid reflux, paralytic ileus

GU: renal calculi

Metabolic: hypokalemia, fluid retention, hypernatremia, hyperosmolarity (with overdose), metabolic alkalosis Respiratory: slow and shallow respirations, cyanosis, apnea

Other: weight gain, pain and inflammation at I.V. site

Interactions

Drug-drug.Anorexiants, flecainide, mecamylamine, methenamine, quinidine, sympathomimetics: increased urinary alkalization, decreased renal clearance of these drugs

Chlorpropamide, lithium, methotrexate, salicylates, tetracycline: increased renal clearance and decreased efficacy of these drugs

Enteric-coated tablets: premature gastric release of these drugs

Drug-diagnostic tests.Lactate, potassium, sodium: increased levels

Drug-herbs.Oak bark: decreased sodium bicarbonate action

Patient monitoring

When giving I.V., closely monitor arterial blood gas results and electrolyte levels.

Stay alert for signs and symptoms of metabolic alkalosis and electrolyte imbalances.
• Monitor fluid intake and output. Assess for fluid overload.

Avoid rapid infusion, which may cause tetany.
• Watch for inflammation at I.V. site.

Patient teaching

• Tell patient using drug as antacid that too much sodium bicarbonate can cause systemic problems. Urge him to use only the amount approved by prescriber.
• Advise patient not to take oral form with milk. Caution him to avoid the herb oak bark.
• Tell patient sodium bicarbonate interferes with action of many common drugs. Instruct him to notify all prescribers if he's taking oral sodium bicarbonate on a regular basis.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, and herbs mentioned above.

so·di·um bi·car·bon·ate

used as a gastric and systemic antacid, to alkalize urine, and for washes of body cavities.

sodium bicarbonate

n.
See baking soda.

sodium bicarbonate

a common salt (baking soda). Sodium is the most important cation in the extracellular fluid, and bicarbonate is the most import buffer in the body. Also called sodium acid carbonate.
indications It is prescribed in the treatment of metabolic acidosis, gastric hyperacidity, and hyperkalemia to alkalinize the urine as part of the treatment for certain poisonings.
contraindications Alkalosis, hypernatremia, hypocalcemia, severe pulmonary edema, and abdominal pain of unknown cause prohibit its use. It should be administered in cardiac arrest only when there is documented metabolic acidosis of hyperkalemia.
adverse effects Among the more serious adverse effects are tetany, gastric distension, acid rebound, bicarbonate-induced alkalosis, hypernatremia, hypocalcemia, and hypokalemia.

so·di·um bi·car·bon·ate

(sōdē-ŭm bī-kahrbŏ-nāt)
Used as a gastric and systemic antacid, to alkalize urine, and for washes of body cavities.

sodium bicarbonate

Baking soda. An antacid drug used to relieve indigestion, heartburn and the pain of peptic ulcer. Sodium bicarbonate is not a preferred antacid as it leads to the production of carbon dioxide and ‘rebound’ acid production.

so·di·um bi·car·bon·ate

(sōdē-ŭm bī-kahrbŏ-nāt)
Agent used as a gastric and systemic antacid, to alkalize urine, and for washes of body cavities.
Synonym(s): baking soda.

sodium

a chemical element, atomic number 11, atomic weight 22.990, symbol Na. See Table 6. Sodium is the major cation of the extracellular fluid (ECF), constituting 90 to 95% of all cations in the blood plasma and interstitial fluid; it thus determines the osmolality of the ECF.

sodium acetate
a systemic and urinary alkalizer.
sodium acetylsalicylate
aspirin.
sodium acid phosphate, sodium biphosphate
used as a dietary supplement of phosphorus for ruminants when only phosphorus is required and in small animals as a urinary acidifier.
sodium aminoarsonate
used as a feed additive to chickens and may cause arsenic poisoning if the dose rate is exceeded.
sodium antimony gluconate, sodium stibogluconate
a pentavalent antimonial used in the treatment of leishmaniasis.
sodium arsanilate
used as a feed additive in the treatment of swine dysentery and in poultry and causes arsenic poisoning when dose rates are excessive.
sodium arsenite
used as a topical acaricide. See inorganic arsenic poisoning.
sodium arsenate
like the arsenite, a toxic compound used as an acaricide. Less toxic and less effective than the arsenite. See also inorganic arsenic poisoning.
sodium ascorbate
a form of ascorbic acid; vitamin C.
sodium azide
used in weed control and the prevention of rot in fruit; used in serum samples to prevent bacterial overgrowth.
sodium bentonite
sodium benzoate
used topically as an antifungal agent in companion animals, with caffeine as a CNS stimulant and as a diagnostic aid in a liver function test.
sodium bicarbonate
a white powder found in most households in the form of baking soda; called also bicarbonate of soda. Used as a gastric antacid and as a systemic and urinary alkalinizer. See also milk shake. Used locally to remove mucus and to remove exudates and scabs.
sodium cacodylate
an organic compound yielding trivalent inorganic arsenic on metabolism in the body, similar in effects and toxicity to arsenic trioxide. Formerly used as a systemic treatment for chronic skin disease and capable of causing arsenic poisoning if used to excess.
sodium-calcium channels
see channel.
sodium carbonate
Na2CO3⋅H2O, used as an alkalizing agent in pharmaceuticals, and has been used as a lotion or bath in the treatment of scaly skin, and as a detergent in companion animals.
sodium channels
see channel.
sodium chlorate
an oldfashioned herbicide which is quite palatable to farm animals and toxic in moderate amounts. Large doses cause abdominal pain, staggering and purging. Lower doses cause methemoglobinemia and dyspnea.
sodium chloride
salt; a necessary constituent of the body and therefore of the diet; sometimes used parenterally in solution to replenish electrolytes in the body.
sodium chloride nutritional deficiency
not a common occurrence but is seen in grazing animals on sodium deficient pastures, where heavy potash fertilizer has been applied in animals that are milking heavily, growing rapidly or losing a lot of sweat. Signs include pica, e.g. drinking urine, polydipsia, polyuria and decrease in appetite, milk yield, body weight, and urinary sodium and chloride.
sodium chloride poisoning (salt poisoning)
can occur via the diet due to accidental inclusion of too much salt; is usually too unpalatable. Most common is drinking of natural saline water from bore or deep well. Causes gastroenteritis, diarrhea and dehydration most noticeable in lactating animals. Animals are restless and play with water, looking for fresh water. Water contains also magnesium, sulfate and carbonate ions. If water intake restricted and salt intake normal a relative poisoning occurs. If combined with water deprivation causes polioencephalomalacia when the water intake returns to normal. In pigs the brain lesion is similar but because of the extensive infiltrations of eosinophils, characteristic of pigs, it is called eosinophilic meningoencephalitis.
sodium chloroacetate
a herbicide with very low toxicity potential.
sodium citrate
an alkalinizing agent; used also as an in vitro anticoagulant in blood stored for transfusion or diagnostic use.
sodium cyanide
a highly toxic industrial chemical and unlikely to enter the animal food chain unless as a result of a spill of reagents or industrial waste.
sodium diethyldithiocarbamate
a chelating agent used in the treatment for thallium poisoning; also used as an immunomodulator in the treatment of human immunodeficiency virus infection in humans.
sodium fluoride
a white, odorless powder used at one time for the treatment of ascariasis in pigs. Has no use in veterinary medicine comparable to its use as a prophylactic against dental caries in humans. See also fluorosis.
sodium fluoroacetamide
1081; causes poisoning similar to sodium fluoroacetate (below).
sodium fluoroacetate
occurs naturally in some plants and used in agriculture as a rodenticide known as 1080. The latter is a restricted substance and is only sold on license. Two forms of poisoning occur: (1) myocardial failure resulting in sudden death in herbivora; signs are dyspnea, cardiac irregularity; (2) excitement and convulsions in pigs and dogs. Both poisonings are highly fatal. Plants containing fluoroacetate are Gastrolobium spp., Acacia georgina (gidgee), Dichapetalum spp., Palicourea spp.
sodium fluorosilicate
is used as an insecticide in bait form for crickets and grasshoppers and as an insecticide dust for poultry. It is as toxic as sodium fluoride.
sodium glutamate
the monosodium salt of l-glutamic acid; used in treatment of encephalopathies associated with liver diseases. Also used to enhance the flavor of foods.
sodium homeostasis
maintenance of the body's sodium status at an appropriate level; effected principally by aldosterone increasing tubular resorption of sodium from the glomerular filtrate.
sodium hyaluronate
used in the treatment of degenerative joint disease in horses. See also hyaluronic acid.
sodium hydroxide
an all-purpose caustic. Its biggest use in veterinary science is to clean down fat-laden surfaces in abattoirs prior to disinfection.
sodium hypochlorite
a compound having germicidal, deodorizing and bleaching properties; used in solution to disinfect utensils, and in diluted form (Dakin's solution) as a local antibacterial and to irrigate wounds. A common disinfectant for a wide variety of uses in veterinary medicine, including application to cow's teats in mastitis control programs. Called also bleach.
sodium iodide
a compound used as a source of iodine and as an expectorant. At times used parenterally in the treatment of extensive ringworm, actinobacillosis and actinomycosis. Overuse causes iodism.
sodium lactate
a compound used in solution to replenish body fluids and electrolytes.
sodium lauryl sulfate
an anionic surface-active agent used in shampoos as a detergent and wetting agent to increase skin penetration of active ingredients.
sodium metabisulfite
used as an antioxidant and as an aid in the making of ensilage. Also used as a preservative on meat, as a source of sulfur dioxide.
sodium methanearsonate
a herbicide—monosodium acid methanearsonate—causes arsenic poisoning.
sodium molybdate
used in salt mixture and as pasture topdressing as a prophylaxis against chronic copper poisoning in ruminants.
sodium monofluoroacetate
see sodium fluoroacetate (above).
sodium nitrate
used in food preservation especially meat pickling and as a fertilizer. Can cause nitrate-nitrite poisoning or nitrite poisoning in ruminants.
sodium nitrite
a vasodilator; used in the treatment of cyanide poisoning. Can cause methemoglobinemia and death from anoxia.
sodium oleate
used by local injection in horses to cause inflammation and aid healing of chronic injuries such as splints and bucked shins.
sodium oxalate
see soluble oxalate poisoning.
sodium pentachlorophenate
used as a fungicide in wood preservatives. Acute poisoning after heavy dosing causes dyspnea and death due to respiratory failure.
sodium perborate
an oxidizing agent; used as a topical antiseptic and mouthwash.
sodium phosphate
an osmotic cathartic.
sodium-potassium-ATPase pump
see pump.
sodium-potassium channels
see channel.
sodium/potassium ratio
a low ratio, indicating hyponatremia and hyperkalemia, is characteristic of hypoadrenocorticism.
sodium propionate
used in the prophylaxis and treatment of acetonemia in cows, and as a fungistat both topically and in preparations for animal medication.
sodium pump
see sodium pump.
sodium-restricted diets
used in the dietary management of heart disease and hypertension in dogs and cats.
sodium salicylate
an analgesic, antipyretic compound. See salicylate.
sodium selenite
used as treatment for severe nutritional deficiency of selenium. Overdose will cause poisoning by selenium.
sodium sulfanilate
rate of excretion is used as a sensitive test of urinary function. See also sulfanilate.
sodium sulfate
an osmotic cathartic; also used as a diuretic and sometimes applied topically in solution to relieve edema and pain of infected wounds. Called also Glauber's salts.
sodium sulfite test
1. precipitates protein out of solution; a dramatic test for protein in urine.
2. a turbidity test on serum for proximate estimation of gamma globulin content and immunological status of newborn calf.
sodium tetraborate
called also borax; used as a weak disinfectant.
sodium thiosulfate
a compound used in the treatment of cyanide poisoning, and used in measuring the volume of extracellular body fluid and the renal glomerular filtration rate.
sodium trichloroacetate
a nontoxic herbicide.
sodium versenate
see edetate.