Electrolyte

Question 1

Sodium Bicarbonate (NaHCO3)

• Functional Class

Answer 1

• Electrolyte, Alkalizing Agent

Question 2

Sodium Bicarbonate (NaHCO3):

• Mechanism of action

Answer 2

• Administered IV. immediately raises the pH
• Buffers H+ Cations
• Excess is excreted in the urine, urine is less acidic

Question 3

Sodium Bicarbonate (NaHCO3):

• Indications

Answer 3

• Severe acidosis (refractory to hypoventilation)
• Tricyclic Antidepressant (TCA) Overdose
• Barbiturate Overdose
• Known Hyperkalemia

Question 4

Sodium Bicarbonate (NaHCO3):

• Contraindications

Answer 4

• None

Question 5

Sodium Bicarbonate (NaHCO3):

• Dosage/Route:

Answer 5

• 1mEq/kg IVP/IO, repeat at 0.5 mEq/kg q 10 min prn.

Question 6

Mag Sulf

• Functional Class

Answer 6

• Electrolyte

Question 7

Mag Sulf

• Mechanism of Action

Answer 7

• Necessary for many biochemical processes and plays a role in the transmission of electrical impulses
• Blocks Ca+ channels and neuromuscular transmission
• Effective treatment for seizures associated with eclapmsia or pregnancy. Depresses CNS, decreasing the amount of Ach released by motor nerve terminals
• Hypomagnesemia can cause dysrhythmias

Question 8

Mag Sulf

• Indications

Answer 8

• Eclampsia
• Torsades
• Asthma

Question 9

Mag Sulf

• Contraindications

Answer 9

• Heart Block
• Shock
• Hypocalcemia
• Persistent HTN
• Myocardial Damage

Question 10

Mag Sulf

• Precautions

Answer 10

• Renal Failure
• Digoxin
• CNS Depression
• Neuromuscular Blocking Agents

Question 11

Mag Sulf

• Side Effects

Answer 11

• Hypotension
• Sedation
• Confusion
• Bradycardia
• Prurits arrhythmias
• Decreased deep tendon reflex
• Resp depression/paralysis
• Muscle Weakness
• Complete Heart Block
• Fetal:
  > Hypoxia
  > Asphyxia
  > Arrythmias
  > Fetal ICP

Question 12

Mag Sulf

• Interactions

Answer 12

• Cardiac conduction abnormalities w/ digitalis

Question 13

Mag Sulf

• Dosage/Route

Answer 13

• Eclampsia: 2-4 g slow IVP in 10 mL NS over 5 min
• Torsades: 1-2 gTVP in 10 mL NS
• Asthma: 2 g slow IVP in 100 mL NS over 10 minutes

Question 14

Mag Sulf

• Note

Answer 14

• Ca+ Chl- is antidote

Question 15

Ca+Chl-:

• Mechanism of Action

Answer 15

• Replaces Ca+, necessary for regulating excitation threshold of muscles and nerves.
• Increases myocardial contractile force and ventricular automaticity.
• Essential for blood clotting mech, renal function maintenance, and bone tissue.
• Antidote for mag OD
• 3x as much elemental Ca+ than Ca+ gluconate

Question 16

Ca+Chl-:

• Indications

Answer 16

• Ca+ blocker toxicity/OD
• Prophylactically prior to IV CCB
• Acute hyperkalemia
• Acute hypocalcemia
• Acute hypermagnesemia

Question 17

Ca+Chl-:

• Contraindications

Answer 17

• VF
• Hypercalcemia
• Digitalis Toxicity

Question 18

Ca+Chl-:

• Precautions

Answer 18

• Particulate formation with NA+ HCO3, flush IV in between

- Monitor for necrosis at injection site

Question 19

Ca+Chl-:

• Side Effects

Answer 19

• Arrhythmias including Bradycardia or CA
• Syncope
• Hypotension
• Necrosis with extravasation

Question 20

Ca+Chl-:

• Interactions

Answer 20

• Precipitates Na+ HCO3 when mixed
• Toxicity with Digitalis
• May antagonize effects of CCBs

Question 21

Ca+Chl-:

• Dosage/Route

Answer 21

• Hyperkalemia/CCB OD: 8-16mg/kg of 10% solution slow IVP q 10 min
• Prophylactic Treatment prior to CCB: 2-4 mg/kg of a 10% solution slow IVP