Sodium Bicarbonate G7

Question 1

Sodium Bicarbonate Class

Answer 1

• Systemic hydrogen ion buffer
• Alkalizing agent

Question 2

Sodium Bicarbonate MOA

Answer 2

• Reacts with hydrogen ions to form water and CO2, correcting metabolic acidosis
• Increases blood and urine pH by releasing a bicarbonate ion, which in turns neutralizes a hydrogen ion

Question 3

Sodium Bicarbonate Indications

Answer 3

• Management of cardiac arrest when either hyperkalemia or tricyclic antidepressant (TCA) overdose are suspected
• QRS prolongation in known cases of TCA overdose
• Crush syndrome

Question 4

Sodium Bicarbonate Adult dose

Answer 4

• 1 mEq/kg IV/IO slowly

Question 5

Sodium Bicarbonate Contraindications

Answer 5

• Known hypersensitivity
• Known metabolic or respiratory alkalosis
• Hypokalemia
• Hypocalcemia
• Hypernatremia
- Use with caution in patients with heart failure or renal disease due to the high sodium concentrations produced

Question 6

Sodium Bicarbonate Adverse effects

Answer 6

• Electrolyte imbalance
• Heart failure
• Pulmonary edema secondary to a sodium overload
• Tremors
• Twitching
• Seizures caused by alkalosis

Question 7

Sodium Bicarbonate Pediatric dose

Answer 7

• 1 month or older: 1 mEq/kg IV/IO slow

• Neonate: 1 mEq/kg IV/IO slow of 4.2% sodium bicarb
(Waste 25 mL of 8.4% sodium bicarb, replace with 25 mL NS, makes 50 mL of 4.2% sodium bicarbonate)