Sodium Bicarbonate Intravenous Infusion BP 8.4%

Generic Name: Sodium bicarbonate
Product Name: Sodium Bicarbonate Intravenous Infusion BP 8.4%

Indication

Sodium bicarbonate is administered to treat a serious condition called metabolic acidosis. This is when the acidity of the blood and tissues is abnormally high. It arises when the bodyâ??s normal acid balancing mechanisms fail, for example, in cardiac arrest or severe kidney disease. Sodium bicarbonate is a base and therefore neutralizes the excess acid in the blood and tissues. Conditions which may produce high levels of acid in the blood include diabetes, diseases of the liver, heart or kidney, severe diarrhoea, Addison’s disease, malnutrition or dehydration.

Sodium bicarbonate also changes the acid-alkali balance of the urine, and can be used to speed up the removal of certain substances from the body, and can be used in the treatment of some poisonings.

Action

Bicarbonate in the body acts as a buffer. Excess hydrogen ions react with bicarbonate resulting in the formation of carbon dioxide and water. The former is excreted from the lungs and the latter from the kidneys.

Sodium bicarbonate therapy buffers excess hydrogen ion concentration, raises blood pH, and reverses clinical manifestations of metabolic acidosis, by increasing plasma bicarbonate. It is excreted mainly in the urine, therefore making it alkaline.

Dose advice

Sodium bicarbonate injection is administered intravenously, preferably into a large vein.

Cardiac arrest:
The dose of sodium bicarbonate that needs to be given to the patient to reverse their acidosis is very much dependent on their pH and blood gas analysis before and during treatment.

For adults the recommended dose is 1 mmol/kg (1mL/kg), followed by 0.5 mmol/kg (0.5mL/kg) given at ten minute intervals.
For children the usual recommended dose is 1mmol/kg (1mL/kg) given by slow intravenous infusion.

In infants less than 2 years of age, a 4.2% solution is recommended for intravenous administration at a dose that should not exceed 8mmol/kg/day.

Less urgent forms of metabolic acidosis:
Sodium bicarbonate injection can be added to other intravenous fluids. In older children and adults the dose of bicarbonate that should be given is ~2 to 5mmol/kg bodyweight over a four to eight hour period, depending on severity of the condition and response to the treatment. Initiation of therapy in a stepwise manner is recommended as response is not predictable.

Schedule

Unscheduled

Common side effects

Medicines and their possible side effects can affect individuals in different ways. The following are some of the side effects associated with this type of medicine.
– alkaline body fluids and tissues (alkalosis)
– decreased potassium levels in the blood (hypokalaemia)
– increased irritability or prolonged muscle contractions
– inflammation of the subcutaneous tissue (cellulitis) and ulceration