“Active Ingredients: 84 grams of sodium bicarbonate.
Excipients: water for injection.
Mechanism of action
Sodium bicarbonate introduced into the body quickly absorbs hydrogen ions from the extracellular space, increasing the pH in the body.
Secondary pharmacodynamic properties
Changing sodium bicarbonate levels may alter plasma potassium concentrations. Increasing the concentration of bicarbonate causes potassium to move into the cells, while decreasing the concentration has the opposite effect. This may complicate existing hyperkalemia or cause hypokalemia.
An increase in pH caused by an increase in bicarbonate concentration can lead to a decrease in the concentration of ionized calcium, which is caused by an increase in the binding of calcium to plasma proteins, especially albumin. A decrease in plasma calcium levels may contribute to cardiac depressive effects due to the release of bicarbonate.
Sodium bicarbonate is indicated for:
for the treatment of metabolic acidosis
for alkalinization of urine (in case of poisoning with weak acids (barbiturates, acetylsalicylic acid), to improve the solubility of drugs that are difficult to dissolve in a neutral or acidic environment (methotrexate, sulfonamides), for hemolysis)
Contraindications:
Intravenous drip administration of 8.4% sodium bicarbonate solution is contraindicated in respiratory and metabolic alkalosis, hypernatremia and hypokalemia. Caution should be exercised when administering intravenous drips of 8.4% sodium bicarbonate solution in cases of pulmonary hypoventilation, hypocalcemia, increased plasma osmolarity and the need to limit sodium intake (for example, heart failure, edema, hypertension, eclampsia, severe renal failure).
Pregnancy and breastfeeding
Considering that sodium bicarbonate easily passes through the placental barrier, sodium bicarbonate solutions should be prescribed to pregnant women only if there are clear indications. It is not recommended to use the drug for eclampsia. At the discretion of the doctor, the drug can be used during breastfeeding.
Directions for use and dosage:
The permissible dosage of the drug depends on the degree of acid-base imbalance.
The imported amount of the drug is calculated based on the results of blood gas analysis using the following formula: volume of 8.4% sodium bicarbonate solution (ml) = base deficiency x body weight (kg) x 0.3, where coefficient 0.3 is the ratio of extracellular fluid to total body fluids.
The daily dose of intravenous drip for infants and young children should not exceed 8 mmol per kilogram of body weight. The drug should be administered slowly. It is necessary to carefully control the dosage and speed of instillation. Metabolic acidosis cannot be controlled too quickly. It is recommended that half the calculated dose be administered first, and subsequent dosages adjusted based on the results of the blood gas analysis.
When alkalizing urine, the dosage should be adjusted in accordance with the required urine pH. When injecting, it is necessary to control the acid-base and water balance. Care should be taken not to exceed the maximum instillation rate. The rate of administration in 1 hour should ensure a sodium bicarbonate concentration of up to 1.5 mmol/h per kilogram of body weight, which corresponds to 1.5 ml/h/kg body weight of an 8.4% sodium bicarbonate solution. The maximum daily dosage of the drug is determined individually depending on the degree of correction.”
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