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Sodium Bicarbonate

Sodium Bicarbonate 8.4% and 4.2%


Buffer, Alkalinizing agent, Antacid


    Adult: 1 mEg/kg IV (8.4%). Repeat with 0.5 mEq/kg q 10 minutes.

    Pediatric: 1 mEg/kg IV (8.4%). Repeat with 0.5 mEq/kq q 10 minutes.

    Infant: 1 mEq/kg IV (4.2%) slowly. May repeat in 10 minutes.


    An alkalizing agent used to buffer acids present in the body during and after severe hypoxia. Bicarbonate combines with excess acids (usually lactic acid) present in the body to form a weak, volatile acid. This acid is broken down into CO2 and H2O. Sodiumbicarbonate is effective only when administered with adequate ventilation and oxygenation.


    Metabolic acidosis due to:
      - Salicylate (Aspirin) overdose.
      - Barbiturate overdose.
      - Tricyclic antidepressant overdose.
      - Hyperkalemia.
      - Severe ketoacidosis.
      - Cardiac arrest.
      - Shock.
      - Physostigmine toxicity.
      - Methanol toxicity.
      - Ethylene glycol toxicity.


      Congestive heart failure; alkalotic states.


      Excessive bicarbonate therapy inhibits the release of oxygen. Bicarbonate does not improve the ability to defibrillate. May inactivate simultaneously if administered with catecholamines. Will precipitate if mixed with calcium chloride. Administration should be guided by arterial blood gasses and ph, when available.


      Metabolic alkalosis, hypernatremia, cerebral acidosis, sodium and H2O retention, which can cause CHF.

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