Sodium Bicarbonate

Question 1

Molecule type

Answer 1

NaHCO3

Question 2

Class

Answer 2

Alkalnizing agent

Question 3

Action

Answer 3

Binds with H to form Caebonic acid, which dissociates into CO2 and H2O, with CO2 being excreted by the lungs, thereby decreasing the acidity of blood.
Causes the shift of potassium into cells.

Question 4

Indications

Answer 4

Patients with known preexisting metabolic acidosis IIa (DKA).
Hyperkalemia I
TCA ODs
Phenobarbital ODs
Alkalanize the urine in drug ODs IIa

Question 5

Contraindications

Answer 5

Hypocalcemia

Metabolic and Respiratory alkalosis

Question 6

Side effects

Answer 6

Paradoxical increased inteacellular/tissue acidosis due to increased CO2 generation and inadequate ventilation to rid CO2, which readily diffuses across cell membranes.
Hypernatremia from large sodium load.
Hyperosmolarity from large sodium load.
Metabolic alkalosis.
May shift the oxyhemoglobin dissociation curve to the L, which causes a decrease in the release of CO2 to the tissues.

Question 7

Precautions

Answer 7

Buffering will produce CO2 so ventilations must be adequate.
Catecholamines tend to be deactivated in akaline solutions like NaHCO3.
Do not mix with calcium chloride because it precipitates in the line if not flushed.
Overly aggressive field use may result in metabolic acidosis.
Dosing should ideally be governed by ABG values.