Cardiac: Alkalinizing Agents

Question 1

Sodium Bicarbonate

Onset: immediate
Peak effects: less than 15 minutes
Duration: 1-2 hours
Half-life: N/A

MOA: administered to increase the pH of the urine; used in metabolic acidosis

Answer 1

Class: alkalinizing agent

Description: a salt that provides bicarbonate to buffer metabolic acidosis, which can accompany several disease processes

Indications: cardiac arrest, tricyclic antidepressant overdose; severe acidosis refractory to hyperventilation

Contraindications: alkalotic states

Precautions: use caution in dosage

Side effects: alkalosis

Interactions: most catecholamines and vasopressors (such as dopamine and epinephrine) can be deactivated by sodium bicarb. Will crystalize when used with calcium chloride.

Route: IV

Adult and peds dosage: 1 mEq/kg initially followed by 0.5 mEq/kg every 10 minutes PRN