sodium bicarbonate(redirected from Bell/ans)
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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.
Pharmacologic class: Fluid and electrolyte agent
Therapeutic class: Alkalinizer, antacid
Pregnancy risk category C
Restores body's buffering capacity; neutralizes excess acid
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.
Adults: 300 mg to 2 g P.O. up to q.i.d., given with a glass of water
• Metabolic or respiratory alkalosis
• Severe pulmonary edema
• Vomiting resulting in chloride loss
• Diuretic use resulting in hypochloremic alkalosis
• Acute ingestion of mineral acids (with oral form)
Use cautiously in:
• renal insufficiency, heart failure, hypertension, peptic ulcer, cirrhosis, toxemia
• pregnant patients.
• 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.
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
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
☞ 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.
• 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(sōdē-ŭm bī-kahrbŏ-nāt)
sodium bicarbonateBaking 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)
Synonym(s): baking soda.