Group 7 - Sodium Bicarbonate 8.4%

Question 1

Sodium Bicarbonate 8.4%

Drug Class?

Answer 1

Sodium Bicarbonate 8.4%

Drug Class:

• Buffer

Question 2

Sodium Bicarbonate 8.4%

Mechanism of Action (MOA)?

Answer 2

Sodium Bicarbonate 8.4%

MOA:

• Buffers H⁺ and increases pH

Question 3

Sodium Bicarbonate 8.4%

Indications?

Answer 3

Sodium Bicarbonate 8.4%

Indications:

• Pre-existing metabolic acidosis
• Poisoning of aspirin, cyclic antidepressants
• Cardiac arrest after other interventions and ventilation is adequate

Question 4

Sodium Bicarbonate 8.4%

Contraindications?

Answer 4

Sodium Bicarbonate 8.4%

Contraindications:

• Alkalosis

Question 5

Sodium Bicarbonate 8.4%

Adverse Reactions?

Answer 5

Sodium Bicarbonate 8.4%

Adverse Reactions:

• CV: congestive heart failure, edema secondary to sodium overload
• Metabolic: hyperosmolarity, hypernatremia

Question 6

Sodium Bicarbonate 8.4%

Adult Dose?

Answer 6

Sodium Bicarbonate 8.4% Adult Dose:

• Pre-existing metabolic acidosis: 50 - 100 mEq IV per medical control
• Cardiac arrest: 1 mEq/kg with subsequant doses of 0.5 mEq/kg every 10 minutes after other standard treatment (defibrillation, CPR, intubation, ventilation and more than one trial of epinephrine) has been used

Question 7

Sodium Bicarbonate 8.4%

Pediatric Dose?

Answer 7

Sodium Bicarbonate 8.4% Pediatric Dose:

• 1 mEq/kg IV/IO slowly, if ventilation is adequate according to medical control
• Neonatal dose: 1 mEq/kg IV/IO of 4.2% slowly. Waste 25 mL of 8.4% solution and add 25 mL of NS from IV bag, each mL will contain 0.5 mEq of sodium bicarbonate

Question 8

Sodium Bicarbonate 8.4%

Onset of Action?

Answer 8

Sodium Bicarbonate 8.4%

Onset of Action:

• Seconds

Question 9

Sodium Bicarbonate 8.4%

Peak Effects?

Answer 9

Sodium Bicarbonate 8.4%

Peak Effects:

• 1 - 2 minutes

Question 10

Sodium Bicarbonate 8.4%

Duration of Action?

Answer 10

Sodium Bicarbonate 8.4%

Duration of Action:

• 10 minutes

Question 11

Sodium Bicarbonate 8.4%

AZ Drug Box Minimum Supply?

Answer 11

Sodium Bicarbonate 8.4%

AZ Drug Box Minimum Supply:

• Optional: 100 mEq

Question 12

Sodium Bicarbonate 8.4%

Special Notes?

Answer 12

Sodium Bicarbonate 8.4%

Special Notes:

• Flush tubing before and after administration
• Severe tissue necrosis with extravasation
• Should only be considered for treatment of DOCUMENTED severe acidosis