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9 Cards in this Set
- Front
- Back
- 3rd side (hint)
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What is the chemical formula for sodium bicarbonate?
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NaHCO₃
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The "bi-" prefix means that the anion is the result of one hydrogen ion (H⁺) being added to the carbonate ion (CO₃²⁺)
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What is the functional class of sodium bicarbonate?
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- Electrolyte
- Alkalinizing Agent |
Sodium bicarbonate can also be used as an exfoliant or mouthwash.
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What is the mechanism of action of sodium bicarbonate?
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Given IV, it immediately raises the pH of blood plasma by buffering excess H⁺ cations. Excess bicarbonate ions are excreted in the urine, thus rendering the urine less acidic.
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Sodium bicarbonate is integral to the body's acid-base homeostasis.
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What are the listed indications for sodium bicarbonate?
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- Severe acidosis (refractory to hyperventilation)
- Tricyclic antidepressant (TCA) overdose - Barbiturate overdose - Known hyperkalemia |
Sodium bicarbonate has occasionally been used to treat ASA overdoses.
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What are the listed contraindications for sodium bicarbonate?
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None in the emergency setting
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Some sources list as contraindications patients with metabolic and respiratory alkalosis and in patients with hypocalcemia in which alkalosis may produce tetany. These are the exact opposites of the indications for the drug!
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What are the listed precautions for sodium bicarbonate?
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- Not recommended for routine use in cardiac arrest
- Dosage must be specific to prevent metabolic alkalosis and is thus weight-based |
In patients with diminished renal function, administration of solutions containing sodium ions may result in sodium retention.
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What are the listed side effects for sodium bicarbonate?
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- Severe tissue damage if extravasation occurs
- May produce paradoxical acidosis that can depress cerebral and cardiac function - May cause extracellular alkalosis, which may reduce the concentration of ionized calcium, decrease plasma potassium, and induce a left shift of the oxyhemoglobin curve which may inhibit oxygen release to the tissues and induce malignant arrhythmias |
The tissue acidosis in cardiac arrest is caused by CO₂ accumulation and that is what bicarbonate administration increases when it combines with H⁺ ions.
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What are the listed interactions for sodium bicarbonate?
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- Will deactivate most catecholamines and vasopressors
- Sodium bicarbonate will precipitate when used in conjunction with calcium chloride |
Sodium bicarbonate can react with sodium polystyrene sulfonate, a different treatment for hyperkalemia, and grossly interferes with it.s function.
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What is the dosage and route of sodium bicarbonate?
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1mEq/kg IVP/IO push, repeat at 0.5mEq/kg q10 minutes prn
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The (molar) equivalent, abbreviated Eq, is the amount of a substance that will react with or supply one mole of hydrogen ions (H+) in an acid–base reaction. The prefix "m" is the SI "milli".
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