22/12/2020
SODIUM BICARBONATE
1️⃣ What is it?
An alkalinizing agent that raises blood pH and reverses the clinical manifestations of acidosis (fatigue, confusion, SOB, headache, rapid/shallow breathing, tachycardia)
2️⃣ How does it work?
Bicarb (has an alkaline pH of 8.2) reacts with H+ ions to form water and CO2. It will act as a buffer against acidosis by raising blood pH
3️⃣ Pharmacokinetics:
Onset - 15 mins (IV)
Duration - 1-2 hrs (IV)
Excretion - urine
4️⃣ Administration during cardiac arrest:
IV push in a dose of 50ml, D5W solution
5️⃣ When is it given?
Cardiac arrest (Metabolic acidosis occurs during cardiac arrest due to a buildup of the acid waste materials in the body)
Hyperkalemia
Metabolic acidosis
6️⃣ Adverse effects:
• edema
• hypernatremia, hypocalcemia, hypokalemia
• metabolic alkalosis
• pulmonary edema
• intracranial acidosis
FYI☝🏼
1. This is not a first line med for resuscitation
2. Use cautiously in pts with sodium retention, hx of CHF, renal impairment, cirrhosis, and HTN
3. Category C for pregnancy - not known if the medication is excreted in breast milk
