BENITO, A.

Sodium bicarbonate 50mEq/50 ml syringe Calcium chloride 1gm/10 ml syringe

Brand Name Brand Name
 Alka-Seltzer  CaCl or CaCl2
Dosage Dosage
 Cardiac arrest. Adults: 200-300mEq given rapidly as a 7.5% or 8.4% solution  Adult: 0.5-1g
 Severe metabolic acidosis: 90-180mEq/L at a rate of 1-1.5L during the first hour  Pediatric: 25mg/kg (0.2mL/kg up to 1-10mL/kg) given slowly
 Less severe metabolic acidosis. 2-5mEq/kg Frequency
Frequency  Adult: every 1-3 days (given at a rate not to exceed 13.6-27.3mg/min)
 Less severe metabolic acidosis: given over a 4-8hr period Indications
Indications  For the treatment of hypocalcemia in those conditions requiring a prompt increase in blood
 Treatment of hyperacidity. plasma calcium levels
 Treatment of acute mild to moderate metabolic acidosis due to shock, severe dehydration, Contraindications
anoxia, uncontrolled diabetes, renal disease, cardiac arrest, extracorporeal circulation of  Use to treat hypocalcemia of renal insufficiency.
blood, severe primary lactic acidosis. Side Effects
Contraindications  Most common – peripheral vasodilation with moderate decreases in BP
 Chloride loss due to vomiting or from continuous GI suction. Adverse Effects
Side Effects  Rapid injection may cause the patient to complain of tingling sensations, a calcium taste, a
 Most common – rebound hyperacidity, milk-alkali syndrome sense of oppression or “heat wave”.
Adverse Effects  Injections of calcium chloride are accompanied by peripheral vasodilatation as well as a local
 Edema, Aggravated CHF, Cerebral hemorrhage “burning” sensation and there may be a moderate fall in blood pressure.
Special Precautions Special Precautions
 Use with caution in impaired renal function, toxemia of pregnancy, with oliguria or anuria,  Use usually restricted in children due to significant irritation and possible tissue necrosis and
during lactation, in edema, CHF, liver cirrhosis, with low-salt diets, and in geriatric or post-op sloughing caused by IV calcium chloride.
clients with renal or CV insufficiency with or without CHF Nursing Considerations
Nursing Considerations  Never administer IM or SC
 Assess for edema, which may indicate inability to utilize NaHCO 3  May give undiluted IV push
 BENITO, A.I

Naloxone
Brand Name
 Narcan
Dosage (IM, IV, SC)
 Narcotic overdose. Initial dose: 0.4-2mg IV
 To reverse post-op narcotic depression. Adults initial dose: 0.1-0.2mg increments at 2-3min
intervals then repeat at 1-2hr intervals if necessary.
Frequency
 To reverse post-op narcotic depression: At 2-3min intervals then repeat at 1-2hr intervals if
necessary
Indications
 Complete or partial reversal of narcotic depression, including respiratory depression induced
by natural or synthetic narcotics, propoxyphene, methadone, nalbuphine, butorphanol, and
pentazocine.
Contraindications
 Sensitivity to drug. Narcotic addicts (drug may cause severe withdrawal symptoms). Use in
neonates
Side Effects
 Most common: virtually no pharmacologic effects in the absence of opioids
 N&V, sweating, hypertension, tremors, sweating due to reversal of narcotic depression.
 If used post-op, excessive dose may cause VT and fibrillation, hypo/hypertension, pulmonary
edema and seizures (infrequent).
Adverse Effects
 Fever, sweating, runny nose, sneezing, goose bumps, yawning, weakness, shivering or
trembling, nervousness, restlessness or irritability, diarrhea, nausea or vomiting, stomach
cramps, fast heartbeat, and increased blood pressure
Special Precautions
 If given during labor, may cause severe hypertension in the mother with mild to moderate
hypertension.
Nursing Considerations
 Do not confuse with naloxone with naltrexone