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Sodium Bicarbonate
trade name
NaHCO3
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Sodium Bicarbonate
class
Alkalinizing Agent
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Sodium Bicarbonate
mechanism of action
- Increases blood pH by neutralizing excess buildup of acids
- Decreases precipitation of myoglobin in renal tubules
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Sodium Bicarbonate
indications
- Cardiopulmonary Arrest with:
- unsuccessful drug therapy and defibrillation
- suspected tricyclic overdose (acidosis)
- suspected hyperkalemia (elevated potassium in dialysis patients)
Crush syndrome or crush injury greater than 4 hours
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Sodium Bicarbonate
contraindications
none
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Sodium Bicarbonate
side effects
- Neurological: headache, confusion, tetany (intermittent tonic spasms), seizures
- Respiratory: pulmonary edema
- Other: metabolic alkalosis, hypokalemia, hypocalcemia, tissue acidosis
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Sodium Bicarbonate
precautions
- Use with caution in patients with CHF
- Administer for crush syndrome prior to removal of entrapped patient
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Sodium Bicarbonate
interactions
Flush IV before and after administration as it will precipitate with calcium chloride and inactivates catecholamines
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Sodium Bicarbonate
routes
IV, IO
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Sodium Bicarbonate
onset and duration
Onset is immediate and may last 1-2 hours
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Sodium Bicarbonate
dosages
- Adult: 1 mEq/kg IV/IO
- Pediatric: 1 mEq/kg IV/IO
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Sodium Bicarbonate
notes
Verify IV patency before administration as it will cause tissue necrosis
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