Sodium bicarbonate

Sodium bicarbonate is a solution of a perfusion type, a blood substitute. Included in the category of electrolyte solutions.

[1], [2],

Indications of the sodium bicarbonate

It is used for metabolic acidosis of uncompensated type with poisonings of different origin, and in addition, if complications arise after surgical operations, with deep or large burns and a state of shock. It is also used for prolonged diarrhea, coma of a diabetic nature, incessant vomiting, severe forms of kidney / liver disease, acute and profuse blood loss, and at the same time with severe hypoxia in newborns and with prolonged fever.

The medicine is introduced without fail, if the patient has a decrease in blood pH to less than 7.2 (in the normal state it should be 7.37-7.42).

[3], [4], [5]

Release form

The release occurs as an infusion solution, in bottles with a volume of 100, 200 or 400 ml.

[6], [7], [8], [9]

Pharmacodynamics

The drug helps to stabilize the alkaline levels of blood, and also to correct metabolic acidosis. During the dissociation of the active substance, a bicarbonate anion is released, which is synthesized with hydrogen ions, resulting in the formation of a carboxylic acid, which later decays to the state of water with carbon dioxide released during the respiration process.

A solution showing a pH level of 7.7-7.9 prevents the possibility of abrupt alkalization, and also promotes a smooth change in acidosis, together with this, increasing the values of alkaline blood reserves.

Along with this, the drug increases the excretion of chloride and sodium ions from the body, increases the osmotic form of diuresis, helps alkalinize urine and prevents the appearance of uric acid as a sediment within the urinary system. Bicarbonate anion is not able to pass into cells.

[10], [11], [12], [13], [14]

Dosing and administration

For adults, the solution is given either in rectal drop form or in / in injection, and for children - by intravenous drip. Given the severity of the developed acidosis, the drug can be diluted with a 5% solution of glucose (ratio 1k1).

In / in the injection of adults should be performed at a rate of about 60 drops / minute, and not more than 200 ml / day. Calculate the size of the dose is required taking into account the level of blood gases by the following formula:

The indicator of the volume of 0.5 molar sodium bicarbonate (buffer) 4.2%, calculated in ml, is equal to the deficit of the bases (exponent -VE) multiplied by kg of the patient's weight, also multiplied by 0.3x2 (the value of 0.3 is the fraction extracellular fluid in relation to the total liquid level).

For children older than 1 year of age, the solution is prescribed in portions of 5-7 ml / kg of body weight.

The maximum permissible adult daily dose of LS is 300 ml (if the patient is overweight, then 400 ml) per day. The child can be administered per day in the range of 100-200 ml of the solution (depending on the weight).

Use of the sodium bicarbonate during pregnancy

There is no information on the use of the solution during lactation / pregnancy. The drug is allowed to be prescribed exclusively in cases where the likely benefit for a woman will exceed the risk of complications in the fetus.

Use the solution for breastfeeding is allowed only for life-threatening disorders.

Contraindications

Among the contraindications:

• metabolic or respiratory alkalosis;
• hypokalemia or hypernatremia;
• children's age less than 1 year.

[15], [16]

Side effects of the sodium bicarbonate

The main side effects: vomiting with nausea, and in addition headaches and stomach pains, anxiety, anorexia, seizures, increased values of AD and alkalosis.

[17]

Overdose

As a result of drug poisoning, hypernatremia, hypercalcosis, and also tetranic type cramps and hyperosmia can occur.

If the patient has symptoms of alkalosis (convulsions develop (also with signs of tetany), a feeling of excitement, pH and sodium levels increase, and in addition calcium decreases with potassium), it is required to stop the injection of the solution. Further, if necessary, introduce a solution of glucose (5%) or sodium chloride.

If there is a risk of tetany, an adult should make an IV injection of calcium gluconate (1-3 g).

[18], [19], [20], [21], [22], [23]

Interactions with other drugs

The solution can potentiate the hypotensive properties of the reserpine substance.

[24]

Storage conditions

Sodium bicarbonate is required to be kept out of the reach of children. The solution should not be frozen. The temperature during storage should not exceed 25 ° C. If precipitation occurs, apply the solution is prohibited.

[25], [26], [27]

Shelf life

Sodium bicarbonate is allowed to be used for 2 years from the date of manufacture of the drug solution.

[28], [29]