Pharmacology Chapter. Page Contents Precautions Not a first line drug for Resuscitation Treat acidosis with ventilation and perfusion Bicarbonate has not been shown to improve survival Bicarbonate may transiently depress CV parameters Cardiac Function Coronary Artery perfusion. Preparations: Intravenous Concentrations Bicarbonate 4. Images: Related links to external sites from Bing.
Related Studies. How do you increase your bicarbonate levels? For example, your doctor may give you sodium bicarbonate baking soda to raise the pH of your blood. This can be done either by mouth or in an intravenous IV drip. The treatment for other types of acidosis can involve treating their cause.
Why do you give Bicarb during a code? Sodium Bicarbonate: corrects metabolic acidosis during a cardiac arrest. Metabolic acidosis occurs after the heart stops, due to a buildup of the acid waste materials in the body.
This condition will be corrected by regularly administering approx every 10 minutes the sodium bicarbonate. What are the symptoms of low bicarbonate? Low bicarbonate levels in the blood are a sign of metabolic acidosis. It is a base, the opposite of acid, and can balance acid. However, you may experience: Long and deep breaths.
Fast heartbeat. Feeling very tired. Why do you give sodium bicarbonate? Solutions containing sodium ions should be used with great care, if at all, in patients with congestive heart failure, severe renal insufficiency and in clinical states in which there exists edema with sodium retention.
In patients with diminished renal function, administration of solutions containing sodium ions may result in sodium retention.
The potentially large loads of sodium given with bicarbonate require that caution be exercised in the use of sodium bicarbonate in patients with congestive heart failure or other edematous or sodium retaining states, as well as in patients with oliguria or anuria. Caution must be exercised in the administration of parenteral fluids, especially those containing sodium ions, to patients receiving corticosteroids or corticotropin.
Potassium depletion may predispose to metabolic alkalosis and coexistent hypocalcemia may be associated with carpopedal spasm as the plasma pH rises. These dangers can be minimized if such electrolyte imbalances are appropriately treated prior to or concomitantly with bicarbonate infusion. A solution diluted to 4. In emergencies such as cardiac arrest, the risk of rapid infusion must be weighed against the potential for fatality due to acidosis. Additives may be incompatible; norepinephrine and dobutamine are incompatible with sodium bicarbonate solution.
The addition of sodium bicarbonate to parenteral solutions containing calcium should be avoided, except where compatibility has been previously established. Precipitation or haze may result from sodium bicarbonate-calcium admixtures. Note: Do not use the injection if it contains precipitate. Additives may be incompatible. Consult with pharmacist, if available. When introducing additives, use aseptic technique, mix throughly and do not store.
The aim of all bicarbonate therapy is to produce a substantial correction of the low total CO2 content and blood pH, but the risks of overdosage and alkalosis should be avoided. Hence, repeated fractional doses and periodic monitoring by appropriate laboratory tests are recommended to minimize the possibility of overdosage. Pregnancy Category C: Animal reproduction studies have not been conducted with sodium bicarbonate.
It is also not known whether sodium bicarbonate can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Sodium bicarbonate should be given to a pregnant woman only if clearly needed. Overly aggressive therapy with Sodium Bicarbonate Injection, USP can result in metabolic alkalosis associated with muscular twitchings, irritability and tetany and hypernatremia.
Inadvertent extravasation of intravenously administered hypertonic solutions of sodium bicarbonate have been reported to cause chemical cellulitis because of their alkalinity, with tissue necrosis, ulceration or sloughing at the site of infiltration. Prompt elevation of the part, warmth and local injection of lidocaine or hyaluronidase are recommended to prevent sloughing of extravasated IV infusions.
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