Uses of bicarbonate
Sodium bicarbonate to reduce the risks of metabolic acidosis in severe kidney disease, vascular insufficiency caused by shock or severe dehydration, cardiac arrest and severe primary lactic acidosis, as an adjunct in severe diarrhea (where a large amount of bicarbonate is lost) It is used in the treatment of poisoning with drugs such as barbiturates or salicylates and also as an alkalinizer of urine to increase the solubility of sulfonamides and prevent crystal formation and possible kidney damage. Sodium bicarbonate is used to control high blood potassium in emergency cases.
Mechanism of action of bicarbonate
Sodium bicarbonate increases plasma bicarbonate concentration, buffers a lot of hydrogen ions and increases blood pH, and as a result, eliminates the clinical manifestations of acidosis. As a urine alkalinizer, this drug increases the excretion of free bicarbonate ions and therefore raises the pH of urine.
Pharmacokinetics of bicarbonate
Excretion of this drug is renal. The carbon dioxide produced by the medicine is removed by the lungs.
Do not use bicarbonate
This medicine should not be used in metabolic or respiratory alkalosis, reduction of chloride ion caused by vomiting or continuous emptying of the digestive system, and low calcium in the blood.
Side effects of bicarbonate
-Exacerbated CHF, cerebral hemorrhage, edema, hypernatremia, hypocalcemia, hypokalemia, metabolic alkalosis, tetanus-like symptoms.
Bicarbonate drug interactions
– The most important interactions of this drug are:
– In case of urine alkalinization, sodium bicarbonate increases the half-life of quinidine, ephedrine and pseudoephedrine and increases the excretion of tetracyclines, salicylates, chlorpropamide and lithium.
– Taking this drug together with corticosteroids may increase sodium retention.
ACE inhibitors can lead to drug intolerance and allergic side reactions, and their simultaneous use should be done with caution.
Bicarbonate warnings
1. This medicine should be used with caution in the following cases:
Anuria or low urine output, sodium retention disease states with urination (such as liver cirrhosis, congestive heart failure, kidney failure and pregnancy toxemia) and high blood pressure.
2. Since metabolic acidosis is associated with sodium excretion, it is better to first compensate for the decrease in blood sodium by intravenous infusion of isotonic sodium chloride, provided that the kidneys are not affected and the acidosis is not so severe that it causes a defect. Complete the work. In such conditions, the use of isotonic sodium chloride solution alone can be effective and cause the kidney’s ability to produce bicarbonate to be restored.
. In renal acidosis or severe metabolic acidosis (for example, in a case where the blood pH is less than 1.7), sodium bicarbonate solution is infused with sodium chloride.
4. Long-term treatment with sodium bicarbonate is not recommended, because there is a risk of metabolic alkalosis or excessive increase of sodium.
5. Consuming excessive amounts may cause low blood potassium levels and expose the patient to the risk of cardiac arrhythmia.
6. Rapid drug injection may cause severe alkalosis and possibly high excitability or tetany.
Bicarbonate drug recommendations
All injectable drugs must be injected in medical centers. Avoid injecting medicine at home.
– Do not inject the drug if the injection solution becomes cloudy or has a certain color change.
Periodic blood tests prescribed by the doctor are mandatory for you.
– Due to the presence of salt in this medicine, inform your doctor if a low-salt diet is recommended for you.
If you have severe abdominal pain, inform your doctor or pharmacist.
