Sodium BICARBONATE

1) Therapeutic drug action & mechanism(pharmacology)

• Systemic alkalisation

2) Indications

• Correction of metabolic acidosis

• Used as a buffer in cardioplegic solutions

3) Effects on organs—side effects

4) Toxic effects/ precautions with administration

• Monitor blood gases especially for PCO2 & pH

5) Contraindications

• Respiratory alkalosis

• Renal failure

• Hypokalaemia

• Hypocalcaemia

6) Reversal, antagonism or antidote

• Stop bicarbonate infusion, patient managed according to degree of alkalisation: severe alkalosis [hyperirritability; tetany] give calcium gluconate, &/or an acidifying agent such as ammonium chloride

7) Loading dose, maintenance dose, frequency & method of administration

• 8.4% in 50 ml water: 1 mEq of sodium & bicarbonate per ml

8) Drug’s metabolism—Drug’s excretion—Half life (pharmacokinetics)

9) Important drug interactions

• Avoid adding to parenteral solutions containing calcium as a precipitation may ensue