BIOCHEM LEC

ACIDOSIS
- more hydrogen ion, lesser bicarbonate, higher carbon dioxide
ALKALOSIS
- more hydroxide ion, more bicarbonate, lower carbon dioxide

**Bicarbonate = alkaline, vital component of the pH buffering system of the body. It

maintains the acid-base homeostasis. If it becomes excessive, you have acidosis.

FACTORS AFFECTING BLOOD pH

1. Nature of Diet

Metabolism
> means conversion of food into energy
> it requires the use of chemical reaction, it is comparable to combustion or
making fire
> Need Digestive Enzymes to breakdown food we eat:
Amylase (breakdown carbohydrate),
Lipase (breakdown fats),
Trypsin (breakdown proteins)
> Ash Residue
*once metabolism is done, there will be a metabolic waste/ash residue
*can be either acidic ash or alkaline ash
*acidic ash = foods rich in protein, fats, ketogenic substances, phosphate
and sulfur
(tends to be more vulnerable in developing disease and acidify your
body)
*alkalinic ash = foods rich in Na sodium, K potassium, calcium and OH
hydroxide (bases)
(it alkalinize your body, meaning it is healthier)
Ex. Fruits and vegetables

2. Vigorous Exercise
> body will undergo ANAEROBIC METABOLISM, in the absence of oxygen, your
body will breakdown glucose and carbohydrates in the body to create energy. This will
result to a buildup of lactic acid, which is a byproduct of anaerobic metabolism, during
an intense exercise/strenuous/vigorous exercise.
> Lactic acid = causes Leg cramps, Myalgia (muscle pain), muscular fatigue
(muscular weakness)
> Tips for Treating Leg cramps: massage the cramped muscle, cool the skin with a
cold, moist cloth, stretch, drink more fluids

ALKALOSIS = Kicks the pH up >7.4

ACIDOSIS = Sliding the pH down < 7.4
ACIDOSIS

3 TYPES OF ACIDOSIS

1. Gaseous acidosis
- more than the normal amount of CO2 is retained in the body. E.g. drowning
> HYPERCAPNIA = accumulation or build up of carbon dioxide in the body, having
a more than normal amount of carbon dioxide
> HYPO-VENTILATING = lung problem, CO2 cannot go out and not exhaled
properly
H2CO3 = Carbonic acid
H2O + CO2 thru the process of ionization

2. Renal acidosis
- kidney failure results in excessive loss of bicarbonate or retention of phosphoric and
sulfuric acids (especially, the kidney tubes/renal tubes, responsible for filtering waste
product)
- role of bicarbonate = vital role in the pH buffering system of the body

3. Patients with diabetes mellitus

- have a form of acidosis in which sodium, potassium and ketone bodies are lost in the
urine
- lack of insulin produced by the pancreas or no insulin at all (beta cell of islets of
langerhans)
- breakdown of fatty acids, there will be production of ketones, or process of
ketogenesis / ketogenesis formation

TYPES OF ACIDOSIS
1. Metabolic Acidosis [Low pH, Low Bicarbonate(HCO3-)]
- occurs when there is excessive loss of bases, such as bicarbonate (HCO3-) or
sodium.
- this is due to a decrease in blood HCO3-.
- CAUSES:
Severe ketosis & Diabetes Mellitus
- accumulation of ketones, when your body senses that your insulin is very low:
(1) the body is a breakdown of glucose/Stored fats in the adipose tissue and
(2) your liver will produce ketones, and delivers it to the bloodstream
(3) there is accumulation o ketones in the blood, resulting to Ketoacidosis
** Diabetic ketoacidosis (DKA)

Eclampsia
- convulsion and seizure occurs to pregnant women suffering from elevated and
uncontrolled hypertension
- it could lead to coma
 High lipid diet
Urinuria - red in the urine
Diarrhea
Starvation or diabetic coma
- TREATMENT:
> administration of SODIUM BICARBONATE along with fluids and other
electrolytes
> metabolic acidosis can be compensated through intravenous

2. Respiratory Acidosis [Hypoventilation, Low pH High PCO2/partial carbon

dioxide)
- associated with an increased level of CO2 in the blood, occurring when there is
interference with respiratory gas exchange.
- carbon dioxide combines with water to form carbonic acid (H2CO3)
- carbonic acid can dissociate into hydrogen ions, which will lower the pH of the blood
(acidosis)
- there is an accumulation of Carbon dioxide due to hypoventilation due to interference
gas exchange or HYPERCAPNIA
- carbon dioxide, if inside the system, it will combine to water H2O. It will create a
form of acid, H2CO3 or carbonic acid.
- carbonic acid, will undergo the process of dissociation. H2CO3 = H + HCO3, will
separate into different ions

- CAUSES:
Depression to respiration/Respiratory Depression
> Opioid Toxicity, Opioid is very strong / regulated pain relievers and
anesthesia used during operation. TOXICITY, there is an overdosage.
>Opioid Analgesics, Morphine = it depresses the respiratory rate and it is a
very potent / very effective opioid analgesics, causing HYPOVENTILATION = CAUSES
CARBON DIOXIDE BUILD UP OR HYPERCAPNIA

Obstruction to respiration/Respiratory Obstruction

> presence of allergic attacks, causing Laryngospasm = sudden constriction
of the walls larynx due to allergic attack, Bronchospasm = sudden constriction of the
muscles in the bronchial wall muscles
> ingestion of foreign material

- TREATMENT:
> respiratory acidosis can be compensated through suction of H2CO3 or through
oxygen tanks
> Acidosis can be compensated through
a. Increase production of ammonia (will bind acid outside) in the kidney
b. Increase excretion of acids by the kidneys
c. Increase excretion of H2CO3 through the lungs

ALKALOSIS
TYPES OF ALKALOSIS
1. Metabolic alkalosis [High pH, High HCO3]
- is usually associated with excessive loss of potassium and chloride. It is due to an
increase in blood HCO3
- CAUSES:
> Overdosage of Alkaline drugs
Alkaline drugs = used to treat gout and hyperuricemia (increase blood uric
acid, too much uric acid deposits)
ex. Calcium carbonate = type of medication that relieves the symptoms of
indigestion, heart burn. Used as a supplement of patient with HYPOCALCEMIA
(decrease serum calcium in the body)
> Excessive loss of gastric HCl due to persistent vomiting or severe committing
(HYPEREMESIS) (Cl - loss)
HCl = strong acid, helps your body to breakdown food, digest food, and
absorb nutrients
> Diarrhea = frequent bowel movement, watery stool
you will experience HYPOKALEMIA (decrease in serum potassium)
2. Respiratory Alkalosis [High pH, low CO2, carbon dioxide level in the body is
below normal amount, due to HYPER VENTILATION)
- produced by hyperventilation (salicylate poisoning or artificial respirator). Which lowers
the CO2 level of the blood.
- due to a decrease in blood H2CO3 due to hyperventilation
- breathing that is abnormally deep in relation to the amount of physical exercise may
lead ti respiratory alkalosis which may produce symptoms of muscular weakness or
cramps

- TREATMENT:
> Alkalosis can be compensated through
a. Decrease production of ammonia by the kidneys
b. Decrease excretion of acids by the kidney
c. Decrease excretion of H2CO3 (volatile acid/liquid, only acid excreted by
the lungs as gas) through the lungs

Alkaline drugs = treat patients with gout and kidney stones

NORMAL VALUES BELOW NORMAL ABOVE NORMAL
pH=7.35-7.45 A=ACIDIC B=BASIC/ALKALINE
PCO2=35-45 B A
H2CO3=22-26 MEq/L A B
PO2= 80 to 100