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Sodium Bicarbonate: (Soe-Dee-Um Bye-Kar-Boe-Nate)
Sodium Bicarbonate: (Soe-Dee-Um Bye-Kar-Boe-Nate)
1 acids; Patients on sodium-restricted diets (oral use as an antacid only); Renal failure
(oral use as an antacid only); Severe abdominal pain of unknown cause, especially if
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sodium bicarbonate (soe-dee-um bye-kar-boe-nate) associated with fever (oral use as an antacid only).
Baking Soda, Bell-Ans, Citrocarbonate, Neut, Soda Mint Use Cautiously in: HF; Renal insufficiency; Concurrent corticosteroid therapy;
Chronic use as an antacid (may cause metabolic alkalosis and possible sodium over-
Classification load); Pedi: Mayqrisk of cerebral edema in children with diabetic ketoacidosis.
Therapeutic: antiulcer agents
Pharmacologic: alkalinizing agents Adverse Reactions/Side Effects
Pregnancy Category C CV: edema. GI: PO— flatulence, gastric distention. F and E: metabolic alkalosis,
hypernatremia, hypocalcemia, hypokalemia, sodium and water retention. Local: ir-
ritation at IV site. Neuro: tetany, cerebral hemorrhage (with rapid injection in in-
Indications fants).
PO, IV: Management of metabolic acidosis. PO, IV: Used to alkalinize urine and pro-
mote excretion of certain drugs in overdosage situations (phenobarbital, aspirin).
Interactions
Drug-Drug: Following oral administration, maypabsorption of ketoconazole.
PO: Antacid. Unlabeled Use: Stabilization of acid-base status in cardiac arrest and Concurrent use with calcium-containing antacids may lead to milk-alkali syn-
treatment of life-threatening hyperkalemia. drome. Urinary alkalinization may result inpsalicylate or barbiturate blood lev-
Action els;qblood levels of quinidine, mexiletine, flecainide, or amphetamines;q
Acts as an alkalinizing agent by releasing bicarbonate ions. Following oral adminis- risk of crystalluria from fluoroquinolones;peffectiveness of methenamine. May
tration, releases bicarbonate, which is capable of neutralizing gastric acid. Thera- negate the protective effects of enteric-coated products (do not administer within
peutic Effects: Alkalinization. Neutralization of gastric acid. 1– 2 hr of each other).
Route/Dosage
Pharmacokinetics Contains 12 mEq of sodium/g.
Absorption: Following oral administration, excess bicarbonate is absorbed and
results in metabolic alkalosis and alkaline urine. Alkalinization of Urine
Distribution: Widely distributed into extracellular fluid. PO (Adults): 48 mEq (4 g) initially. Then 12– 24 mEq (1– 2 g) q 4 hr (up to 48
Metabolism and Excretion: Sodium and bicarbonate are excreted by the kid- mEq q 4 hr) or 1 tsp of powder q 4 hr as needed.
neys. PO (Children): 1– 10 mEq/kg (84– 840 mg/kg) per day in divided doses.
Half-life: Unknown. IV (Adults and Children): 2– 5 mEq/kg as a 4– 8 hr infusion.
TIME/ACTION PROFILE (PO ⫽ antacid effect; IV ⫽ alkalinization) Antacid
ROUTE ONSET PEAK DURATION PO (Adults): Tablets/powder— 325 mg– 2 g 1– 4 times daily or 1⁄2 tsp q 2 hr as
needed. Effervescent powder— 3.9– 10 g in water after meals; patients ⬎60 yr
PO immediate 30 min 1–3 hr should receive 1.9– 3.9 g after meals.
IV immediate rapid unknown
Systemic Alkalinization/Cardiac Arrest
Contraindications/Precautions IV (Adults and Children and Infants): Cardiac arrest/urgent situations— 1
Contraindicated in: Metabolic or respiratory alkalosis; Hypocalcemia; Hyperna- mEq/kg; may repeat 0.5 mEq/kg q 10 min. Less urgent situations— 2– 5 mEq/kg as
tremia; Excessive chloride loss; As an antidote following ingestion of strong mineral a 4– 8 hr infusion.
⫽ Canadian drug name. ⫽ Genetic Implication. CAPITALS indicate life-threatening, underlines indicate most frequent. Strikethrough ⫽ Discontinued.
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CONTINUED
sodium bicarbonate
tin/dalfopristin, sargramostim, trimethoprim/sulfamethoxazole, verapamil,
vincristine, vinorelbine.
● Solution Incompatibility: Do not add to Ringer’s solution, LR, or Ionosol prod-
ucts, as compatibility varies with concentration.
Patient/Family Teaching
● Instruct patient to take medication as directed. Take missed doses as soon as re-
membered unless almost time for next dose.
● Review symptoms of electrolyte imbalance with patients on chronic therapy; in-
struct patient to notify health care professional if these symptoms occur.
● Advise patient not to take milk products concurrently with this medication. Renal
calculi or hypercalcemia (milk-alkali syndrome) may result.
● Emphasize the importance of regular follow-up examinations to monitor serum
electrolyte levels and acid-base balance and to monitor progress.
● Antacid: Advise patient to avoid routine use of sodium bicarbonate for indiges-
tion. Dyspepsia that persists ⬎2 wk should be evaluated by a health care profes-
sional.
● Advise patient on sodium-restricted diet to avoid use of baking soda as a home
remedy for indigestion.
● Instruct patient to notify health care professional if indigestion is accompanied by
chest pain, difficulty breathing, or diaphoresis or if stools become dark and tarry.
Evaluation/Desired Outcomes
● Increase in urinary pH.
● Clinical improvement of acidosis.
● Enhanced excretion of selected overdoses and poisonings.
● Decreased gastric discomfort.
Why was this drug prescribed for your patient?
⫽ Canadian drug name. ⫽ Genetic Implication. CAPITALS indicate life-threatening, underlines indicate most frequent. Strikethrough ⫽ Discontinued.