Major

Intracellular
AND
Extra Cellular
Electrolytes
 ELECTROLYTE
• Electrolyte is the substance cable to produce electricity under the electrical
environment still combination of Anion and Cation
• That is completely ionized or separated into aqueous media that is called
electrolyte and all inorganic compound produce electricity
• Electrolyte are essential for the human body function like that heart, nerves
system and muscular function etc.
Electrolytes Functions
• Prevents from dehydration.
• Maintain the acid-base balance (body pH).
• Maintain the osmotic pressure.
• Body working normally.
• It regulates heart rhythm.
• Regulate muscle contractions.
• Help the brain function.
• Cells can generate energy.
• Cells can maintain the stability of the cell walls.
• Carbon dioxide and Bicarbonate keeps body pH normal.
 INTRACELLULAR FLUID
• The composition of tissue fluid depends upon the
exchanges between the cells in the biological tissue and
the blood. This means that fluid composition varies
between body compartments.
• The cytosol or intracellular fluid consists mostly of water,
dissolved ions, small molecules, and large, water-soluble
molecules (such as proteins).
ELECTROLYT
E PRESENT
IN
BODY FLUID
• Most of the cytosol is water, which makes up about
70% of the total volume of a typical cell and The pH
of the intracellular fluid is 7.4.
• The cell membrane separates cytosol from
extracellular fluid, but can pass through the
membrane via specialized channels and pumps during
passive and active transport.
• The cytosol also contains much higher amounts of
charged macromolecules, such as proteins and
nucleic acids, than the outside of the cell.
• sodium and potassium ion concentrations are Na+/K
ATPase pumps that facilitate the active transport of
these ions. These pumps transport ions against their
concentration gradients to maintain the cytosol fluid
composition of the ions.
 EXTRACELLULAR FLUID

• The extracellular fluid is mainly cations and anions.

• The cations include: sodium (Na+ = 136-145 mEq/L), potassium (K+
= 3.5-5.5 mEq/L) and calcium (Ca2+ = 8.4-10.5 mEq/L). Anions
include: chloride ( mEq/L) and hydrogen carbonate (HCO3- 22-26
mM). These ions are important for water transport throughout the
body.
• Plasma is mostly water (93% by volume) and contains dissolved
proteins (the major proteins are fibrinogens, globulins, and
albumins), glucose, clotting factors, mineral ions (Na+, Ca++, Mg++,
HCO3- Cl- etc.), hormones and carbon dioxide (plasma being the
main medium for excretory product transportation). These
dissolved substances are involved in many varied physiological
processes, such as gas exchange, immune system function, and drug
distribution throughout the body.
 DIFFERENT
BETWEEN
INTRACELLULAR
FLUID AND
EXRACELLUR
FLUID
 Edema
• Condition in which fluid accumulates in the interstitial compartment.
Sometimes due to blockage of lymphatic vessels or by a lack of plasma proteins
or sodium retention

Fluid Balance
• Amount in = amount out
• Average daily intake is 2500 ml [ fluids, food
and metabolic water]
• Average daily output is 2500 ml [ urine,
feces, perspiration, insensible perspiration]

Market Product
 Fluid electrolyte concentrations :

• Each fluid compartment has a distinct solute pattern (as seen in the previous
table).
• The solution in each compartment is ionically balanced.
• Thus, sodium and chloride are found in the plasma and interstitial fluids while
potassium, magnesium and phosphate (as phosphate esters, HPO42-) are found
in intracellular fluid.
 Expression of concentrations

• The concentrations of individual ions are expressed by mEq/l

(milliequivalents/liter) rather than weight/volume (w/v).

• Dosages of individual ions are expressed in mEq/l.

• Equivalent weight is obtained by dividing the atomic or molecular

weight by the valence.
• mEq/l = mg of substance/l ÷ Eq.wt
= mg of substance/l ÷ Mol.wt / Valence

• Calculation of weight of salt necessary to yield the required number

of mEq:
• mg/liter = (mEq/l) (Eq. wt) = (mEq/l)×(Mol.wt/
Valence)
 MAJOR PHYSIOLOGICAL IONS
Chloride :
• It is the major extracellular anion.
• Principally responsible for maintaining proper hydration, osmotic
pressure and normal cation-anion balance in the extracellular fluid
compartments.
• Food is the main source of chloride with the anion being almost
completely absorbed from the intestinal tract.
• Chloride is removed from the blood by glomerular filtration and
possibly is reabsorbed by the kidney tubules.
• Chloride travels primarily with sodium and water and helps generate the
osmotic pressure of body fluids.

• It is an important constituent of stomach hydrochloric acid (HCl), the key

digestive acid.
• Chloride is also needed to maintain the body's acid-base balance. Chloride
may also be helpful in allowing the liver to clear waste products.
 Hypochloremi
a
• Hypochloremia is caused by :

• (i) salt-losing nephritis (inflammation of the kidney)

associated with chronic pyelonephritis (inflammation of the
kidney and its pelvis) leading to a lack of tubular
reabsorption of chloride,

• (ii) metabolic acidosis such as found in diabetes mellitus and

renal failure, causing either excessive production or
diminished excretion of acids leading to the replacement of
chloride by acetoacetate and phosphate

• (iii) prolonged vomiting with loss of chloride as gastric

hydrochloric acid.
 Hyperchloremia
• Dehydration
• Decreased renal blood flow found in congestive heart failure
• Severe renal damage
• Excessive chloride intake
 Bicarbonate

• The bicarbonate ion acts as a buffer to maintain the normal levels

of acidity (pH) in blood and other fluids in the body.

• Bicarbonate levels are measured to monitor the acidity of the blood

and body fluids.

• The acidity is affected by foods or medications that we ingest and

the function of the kidneys and lungs.

• Disruptions in the normal bicarbonate level may be due to

diseases that interfere with respiratory function, kidney diseases,
metabolic conditions
 Phosphate :
It is the principal anion of the intracellular fluid
compartment.
Physiological functions
Hexoses are metabolized as phosphate esters.

The phosphoric acid anhydride linkage is the body’s means of storing

potential chemical energy as adenosine triphosphate (ATP).

 The HPO42- / H2PO4- is an important buffer system, both biochemically and

pharmaceutically.

Calcium metabolism

Phosphorus is essential for normal bone and tooth development-

component of hydroxyapatite
 Hyperphosphatemia
• Hyperphosphatemia is found in Hypervitaminosis D (which
increases intestinal phosphate absorption along with calcium), renal
failure due to the inability to excrete phosphate into the urine and
hypoparathyroidism (lack of parathyroid hormone permits renal
tubular reabsorption of phosphate which results in decreased
urinary phosphate and a rise in serum phosphate.
• Treatment : Basic aluminium carbonate is used to remove dietary
phosphate by excreting it in the faeces as slightly soluble aluminium
phosphate.
Hypophosphatemia
• Hypophosphatemia can be caused by
Vitamin D deficiency (rickets)
decreased intestinal calcium absorption
 hyperparathyroidism
long term aluminium hydroxide gel antacid therapy.
 Sodium
• It is the principal cation in the extracellular fluid.
• More than adequate amounts of sodium are contained in the daily diet with
nearly complete absorption from the intestinal tract.
• Excess sodium is excreted by the kidneys which make them the ultimate
regulator of the sodium content of the body.
• 80-85% of the sodium in the glomerular filtrate is reabsorbed and this
reabsorption is under hormonal control.
Physiological functions
• Sodium regulates the total amount of water in the body and the transmission
of sodium into and out of individual cells also plays a role in critical body
functions.
• Many processes in the body, especially in the brain, nervous system, and
muscles, require electrical signals for communication.
• The movement of sodium is critical in generation of these electrical signals.
 Hyponatremia
- Extreme urine loss such as seen in diabetes insipidus
- Metabolic acidosis in which the sodium is excreted.
- Addison’s disease with decreased excretion of ADH hormone,
aldosterone
- Diarrhea and vomiting
- Kidney damage
Hypernatremia
• Hyperadrenalism (Cushing’s syndrome) with increased
aldosterone production
• Severe dehydration
• Certain types of brain injury
• Excess treatment with sodium salts
 Potassium
• It is the major intracellular cation, present in a
concentration approximately 23 times higher than the
concentration of potassium in the extracellular fluid
compartments.
• This concentration differential is maintained by an active
transport mechanism.
• During transmission of a nerve impulse, potassium leaves
the cell and sodium enters the cell.
• This active transport mechanism has been called the
sodium-potassium pump.
• Potassium in the diet is rapidly absorbed.
• Excess potassium is rapidly excreted by the kidneys.
 Physiological functions
• Maintains the electrolyte balance in your body's cells
• Manages your blood pressure and keeps your heart functioning properly
• Assists nervous system by aiding in the correct function of tissues needed
for sending nerve impulses
• Helps the muscles contract
• Enhances muscle control, the growth and health of your cells
• Promotes efficient cognitive functioning by helping to deliver oxygen to the
brain
 Hypokalemia

• Hypokalemia can occur from vomiting, burns, hemorrhages, diabetic coma,

intravenous infusions of solutions lacking in potassium, overuse of thiazide
diuretics.
• Hypokalemia can cause changes in myocardial function, flaccid and feeble
muscles and low blood pressure.
Hyperkalemia

• Hyperkalemia usually occurs during kidney damage.

• Hyperkalemia causes the heart muscle to become flaccid (by displacing
calcium in the cardiac muscle) and leads to possible cessation of heart
(potassium arrest / Cardiac arrest).
 Magnesium
• It is the second most plentiful cation in the intracellular
fluid compartment.
• Uses: it is an essential component of many enzymes
including phosphate metabolism, protein synthesis and
smooth muscle functioning of the neuromuscular
system.
• Causes of negative magnesium level are malnutrition,
dietary restrictions, chronic alcoholism, faulty
absorption, gastrointestinal diseases, medications and
parathyroid hormone imbalances.
 Magnesium
• Magnesium cation has a definite pharmacological action.
• Magnesium is not readily absorbed from the
gastrointestinal tract because its absorption is retarded
by alkaline media.
• Most of the absorption takes place in the acid medium of
the duodenum.
• Due to the slow absorption of magnesium ions, a saline
laxative action occurs upon the ingestion of any water
soluble magnesium compound.
 Calcium
• 99% of body calcium is found in bones. The remaining Ca is found largely in
extracellular fluid.
• Ca is absorbed from the upper part of the small intestine where the intestinal
contents are still acidic.
• As the intestinal contents remain neutral to basic , Ca is precipitate as the
CaHPO4 , carbonate , oxalate and sulfate salts
• Actual absorption is controlled by parathyroid hormone and metabolite of
Vitamin D

Physiological functions
• Functionally, 99% of all body Ca is supportive, being found in bone as
hydroxyapatite.
• The remaining ionic Ca in involved in neurohormonal functions, muscle
contraction, blood clotting.
• Ca is essential for blood clotting . Anti coagulant is added to whole blood to
complex the blood Ca and thereby prevent the clot formation in the clotted
blood.
 Hypercalcemia
• It can be caused by hyperparathyroidism, hypervitaminosis D and some bone
neoplastic disease.
• Symptoms include fatigue, muscle weakness, constipation, anorexia and
cardiac irregularities.
• If the conditions persists, Ca may be deposited in kidney and blood vessels.

Hypocalcemia & Bone malformation

• It can be caused by hypoparathyroidism, vitamin D deficiency, osteoblastic
metastasis, acute pancreatitis, hyperphosphatemia .
• Associated with the above condition are disorders in bone metabolism.
• Bone is the dynamic tissue involving constant exchange of calcium and
phosphate ions with the body fluids.
• Much of this exchange is under hormonal control.
• Bone, in addition to providing structural support , is also storage tissue for
calcium.
 Electrolyte combination therapy
• In short-term therapy, such as following a surgery, infusion of a standard
glucose and saline solution may be adequate.
• However, when deficits are severe, solutions containing additional
electrolytes are usually required.

• Commercial electrolyte infusion solutions can be divided into two

groups :
1. Fluid maintenance
2. Electrolyte replacement
 Fluid Maintenance therapy
• Maintenance therapy with intravenous fluids is intended to supply
normal requirements for water and electrolytes to patients who cannot
take them orally.
• All maintenance solutions should contain atleast 5% dextrose. This
minimizes the buildup of metabolites such as urea, phosphate and
ketone bodies associated with starvation.
ELECTROLYTE CONCENTRACTION (mEq/L)
Sodium 25-30
Potassium 15-20
Chloride 22
Bicarbonate 20-23
Magnesium 3

phosphorus 3
 Replacement Therapy
• Therapy involving the supply of a substance (such as a hormone or nutrient)
lacking in or lost from the body
• When person suffering from disease
• Prolong fever, Vomating,diarrhoea.
• Due to heavy loss of water and electrolyte therefore,imbalance of electrplyte
in our BODY
Replacement Therapy
• Replacement therapy is needed when there is heavy loss of water and
electrolytes due to prolonged fever, severe vomiting and diarrhea.
• There are usually two types of solutions used in replacement therapy :

• a solution for rapid initial replacement and

• a solution for subsequent replacement.
 Rapid initial replacement
The electrolyte concentration in solutions for rapid initial
replacement are as follows:
ELECTROLYTE Concentraction (mEq/L) for Rapid Initial Replacement

Sodium 130-150

Potassium 4-12

Chloride 98-109

Bicarbonate 28-55

Calcium 3-5

Magnesium 3-5

phosphorus -
 Subsequent replacement
The electrolyte concentration in solutions in subsequent
replacement are as follows:

ELECTROLYTE Concentraction (mEq/L) for Subsequent replacement

Sodium 40-121

Potassium 16-35

Chloride 30-103

Bicarbonate 16-53

Calcium 0-5

Magnesium 0-13

phosphorus 0-13
Official combination electrolyte infusions

Ringer’s Injection
Each liter contains 8.6 g of sodium chloride,
0.3 g of potassium chloride,
0.33 g of calcium chloride.
This is equivalent to 147 mEq/l Na,
4 mEq/l K,
4.5 mEq/l Ca,
155.5 mEq/l Cl.
Usual dose : Intravenous infusion, 1 liter.
Official combination electrolyte infusions

Lactated Ringer’s Injection

Each 100ml contains 600 mg of sodium chloride,
310 mg of sodium lactate,
30 mg of potassium chloride
20mg of calcium chloride.
This is equivalent to 130 mEq/l Na,
4 mEq/l K,
2.7 mEq/l Ca,
109.7 mEq/l Cl
27 mEq/l lactate.z
Usual dose : Intravenous infusion, 1 liter.
Electrolytes used for replacement therapy

Sodium Chloride :
• Occurs as colorless cubic crystals or as a white, crystalline
powder having a saline taste.
• Freely soluble in water, more soluble in boiling water,
soluble in glycerin and slightly soluble in alcohol.

• Uses– replacement therapy, manufacture of isotonic

solutions, flavor enhancer
• In order to be isotonic, a salt should be 0.9% w/v.
Available Forms of Sodium Chloride :

• Sodium Chloride Injection

Contains 0.9% NaCl
Category: Fluid and electrolyte replenisher; irrigation solution

• Bacteriostatic Sodium Chloride Injection

Contains 0.9% NaCl, Category: sterile vehicle

• Sodium Chloride Solution

Contains 0.9% NaCl, Category: isotonic vehicle

• Dextrose and Sodium Chloride Injection

Category: Fluid, nutrient and Electrolyte replenisher
Available Forms of Sodium Chloride :

• Fructose and Sodium Chloride Injection

Contains 10% fructose and 0.9% NaCl
Category: Fluid, nutrient and Electrolyte replenisher

• Ringer’s Injection
Contains 0.86% NaCl
Category: Fluid and electrolyte replenisher
Potassium Chloride
• Occurs as colorless, elongated, prismatic or cubic crystals or as a
white, granular powder.
• Freely soluble in water, more soluble in boiling water, insoluble in
alcohol

• It is the drug of choice for oral replacement of potassium

• It is irritating to the gastrointestinal tract and solutions must be well

diluted and the tablets must be enteric coated.

• Potassium chloride is given alone as an isotonic solution, in an

isotonically balanced sodium chloride solution or as 500ml of 5%
glucose (dextrose) solution containing 40mEq of potassium.
Potassium Chloride

• Indications:
- Hypopotassemia
- Paralysis
- Antidote in digitalis intoxication
- As an adjunct to drugs used in the treatment of
myasthenia gravis (severe muscle weakness).
Available Forms of Potassium Chloride :
• Potassium Chloride Injection
Available as concentrates: 1.5 g in 10ml; 3 g in 12.5ml
• Potassium Chloride Tablets
Available as enteric coated tablets containing 300mg or 1g
• Ringer’s Injection
Contains 0.03% KCl (147mEq/l Na, 4 mEq/l K, 4.5mEq/l Ca,
155.5mEq/l Cl).
Category: Fluid and electrolyte replenisher
Usual Dose : Intravenous infusion, 1 liter
• Lactated Potassium Saline Injection
Contains 0.026% KCl (121mEq/l Na, 35 mEq/l K,
103 mEq/l Cl, 53mEq/l lactate).
Category: fluid and electrolyte replenisher
Potassium Gluconate

• Occurs as a white to yellowish white, crystalline powder or

as granules

• Freely soluble in water, practically insoluble in dehydrated

alcohol, ether, benzene, chloroform.

• Less irritating and easier to use to mask potassium’s saline

taste

• Category : Electrolyte replenisher

• Usual Dose : the equivalent of 10mEq of potassium four

times daily
Potassium Gluconate

• Available forms:

- Potassium Gluconate Elixir

available as an elixir containing 4.68g of potassium
gluconate in each 15ml, equivalent to 20mEq of
potassium

- Potassium Gluconate Tablets

available as sugar-coated tablets containing 1.17 g of
potassium gluconate equivalent to 5mEq of potassium
Calcium replacement :

•Calcium Chloride
•Calcium Gluconate
•Calcium Lactate
•Dibasic Calcium Phosphate
•Tribasic Calcium Phosphate
 Calcium Chloride
• Occurs as white, hard, odorless fragments or granules

• Freely soluble in water, alcohol, boiling alcohol and

very soluble in boiling water.

• It is irritating to the veins and should be injected slowly.

• It is contraindicated in hypocalcemia associated with

renal insufficiency

• Used as a calcium source in many commercially

available electrolyte replacement and maintenance
solutions.
Available Forms of Calcium Chloride :

• Ringer’s Injection
• Contains 0.033%  CaCl2.H2O (147mEq/l Na, 4 mEq/l K, 4.5mEq/l Ca,
155.5mEq/l Cl).

Category: Fluid and electrolyte replenisher

• Lactated Ringer’s Injection

Contains 0.02% CaCl2.H2O (130mEq/l Na, 4 mEq/l K, 2.7mEq/l Ca,

109.7mEq/l Cl, 27mEq/l lactate).

Category: Systemic alkalizer; fluid and electrolyte replenisher.

Calcium Gluconate
• occurs as white crystalline, odorless, tasteless granules or
powder which is stable in air.
• Sparingly soluble in water, freely soluble in boiling water,
insoluble in alcohol

• It is the treatment of choice for hypocalcemia because it is

nonirritating when given orally and intravenously.

• Usual dose : oral 1 g three or more times a day

IV 1g one or more times a day

Available forms :
- Calcium Gluconate Injection (97mg Calcium Gluconate/ml)
- Calcium Gluconate Tablets (500mg and 1g tablets).
Parenteral magnesium administration
Magnesium Sulfate

• Used as a central nervous system depressant in the treatment of

eclampsia (convulsion and coma)

• Used during hypomagnesemia

• Overtreatment with magnesium sulfate can cause respiratory

paralysis and cardiac depression

• Category : anticonvulsant and cathartic

• Usual dose : IV 4 gm in 10% solution

 ORS (ORAL REHYDRATION SALT)
• The oral administration fluid or solution that contain suitable combination of
carbohydrate and electrolyte is called as Oral Rehydration Therapy
• LOSS EXCESSIVE of electrolyte or body fluid by human body due to some
disease at the time recommended ORS or ORT.
• Appropriate Concentration of sodium chloride and glucose 0.9% for oral
administration.
• There are two basic treatment of stage
1. REHYDRATION PHASE: its involved the replacement of fluid and
electrolyte lost through diarrhea
2. MAINTAIN PHASE: its replacement of losses es due to continuing diarrhea
and vomiting and by normal loss due to respiration, sweating, urination
that is observe in infant
ORS (ORAL REHYDRATION SALT)

INGREDIENT FARMULA-1 FARMULA-2 FARMULA-3

Sodium chloride 1.0 gm 3.5 gm 3.5 gm

Potassium chloride 1.5 gm 1.5 gm 1.5 gm

Sodium bicarbonate 1.5 gm 2.5 gm -

Sodium citrate - - 2.9 gm

Anhydrous glucose 36.4 gm 20.0 gm 20.0 gm

Or glucose 40.0 gm 22.0 gm -

PHYSIOLOGICAL ACID-BASE BALANCE
• Physiological Acid-Base Balance or Homeostasis or pH should be
maintained in order for proper functioning of the body.
• Number of chemical reaction exhibited into human body because of
Narrow pH should be stable.
• Human Produce 80 mEq/Day (Milliequivantant per Day) H+ ion
• Hydrogen ion arising by non-volatile acid in which Carbon dioxide and
Latic Acid eliminated from respiration.
• Mainly system involving in the prevention of pH
1.Respiratory System
2.Execratory System
Buffer System into Human Body

• Buffer made up by weak acid and the salt of acid

• Buffer System able to remove the excess H+ from the fluid NOT from
the body.
Mainly three Buffer System into Body
1.Carbonic acid Bicarbonate Buffer system
2.Phosphate Buffer System
3.Protein(Hemoglobin)
 Protein (Haemoglobin) Buffer System
• The protein are building block element of human body and multiple vital
role in human physiology.
• This Made-up of amino acid that has been content Carboxylic acid (COOH)
and amino (NH2) group still Amino acid are amphoteric nature.
• Protein (Haemoglobin) behave as buffer into cell and plasma.
 Carbonate Buffer system

• This buffer system generally occur in plasma and kidney basically essential
of Regulation of Blood pH.

H+ + HCO-3 H2CO3 H2O + CO2

Strong Acid Weak Base Carbonic acid
(Weak Base)

• Normal Metabolism give rise to more acid than base but blood is made more acid.
Therefore body NEED to more bicarbonate salt.
• Bicarbonate ions and carbonic acid are present in the blood in a 20:1 ratio if the blood
pH is within the normal range.
• 20 times more bicarbonate than carbonic acid, this capture system is most efficient at
• buffering changes that would make the blood more acidic
 Phosphate Buffer System

• Phosphate buffer system Composed by Monohydrogen Phosphate /

dihydrogen phosphate
• Generally this system occurring in cell and kidney and its regulated
the pH in intracellular fluid in cytosol.

HCl + Na2HPO4 NaCl + NaH2PO4

NaOH +. NaH2PO4 H2O + NaHPO4

There is two form of phosphate present in blood one is Sodium

Dihydrogen Phosphate as weak acid Similarly, Sodium Monohydrogen
phosphate as weak base
Electrolytes used in acid-base therapy
• Metabolic acidosis is treated with sodium salts of bicarbonate, lactate,
acetate and ocassionally citrate.

• Administration of bicarbonate increases the

HCO3- / H2CO3 ratio when there is a bicarbonate deficit.

• Lactate, acetate and citrate are normal components of metabolism

and will be degraded to carbon dioxide and water. The carbon dioxide
by the action of carbonic anhydrase will form bicarbonate and reduce
the bicarbonate deficit.

• Metabolic alkalosis has been treated with ammonium salts e.g NH4Cl
and it retards Na-H exchange in the kidneys.
Sodium Bicarbonate

•Occurs as a white, crystalline powder which is stable in dry air but

slowly decomposes in moist air

•Solutions are alkaline to litmus

•When heated, the salt loses water and carbon dioxide and is
converted into the normal carbonate.

2 NaHCO3 ——> Na2CO3 + H2CO3

<——
H2CO3 ——> H2O + CO2

•The above decomposition takes place when the dry salt or a

solution is heated.
Importance of sodium bicarbonate :

1. The normal acid-base balance of the plasma is maintained by

three mechanisms working together

- the buffers of the body fluids and red blood cells

- pulmonary excretion of excess carbon dioxide

- renal excretion of either excess acid or base.

sodium bicarbonate :
 The bicarbonate/carbonic acid system is the most important
plasma buffer. This buffer system involves an equilibrium between
sodium bicarbonate and carbonic acid.
 At a given pH, the ratio of the concentrations of the two
substances is constant.

The priniciple is as follows:

If an excess of acid is liberated in the body, it is neutralized by
some of the sodium bicarbonate.

The excess carbonic acid decomposes into water and carbon

dioxide and this carbon dioxide is excreted by the lungs until the
normal bicarbonate/ carbonic acid ratio is achieved.

• H+ + NaHCO3 --------> Na+ +H2CO3

• H2CO3 --------> H2O + CO2
Importance of sodium bicarbonate :
2. Sodium bicarbonate is used in medicine principally for its
acid neutralizing properties. It is used to

• To combat gastric hyperacidity

• To combat systemic acidosis
• For miscellaneous uses

Available forms : Sodium Bicarbonate Injection

Sodium Bicarbonate Tablets
Sodium Citrate
• Occurs as colorless crystals or as a white, crystalline powder

• used as an anticoagulant for whole blood by chelating serum

calcium, thereby removing one of the components of blood
clotting
• Used as buffering agents
• Used in chronic acidosis

• Usual dose : 1 to 2gm every two to four hours as required

• Available forms
– Anticoagulant Citrate Dextrose Solution
- Anticoagulant Citrate Phosphate Dextrose Solution
Ammonium Chloride

• Occurs as colorless crystals or as a white, fine or coarse

crystalline powder
• Has a cool saline taste
• Freely soluble in water and in glycerin, sparingly soluble in
alcohol
• The ammonium cation falls into certain pharmacological
categories :
(1) To treat Acidosis
(2) Diuretic effect
(3) Expectorant effect