DRUG STUDY

GENERIC NAME: Sodium Bicarbonate

Brand name: Sodium Bicarbonate
Drug Classification: Gastrointestinal agent; antacid

DOSAGE, ROUTE, SIDE EFFECTS and

FREQUENCY (prescribed and INDICATION MECHANISM OF ADVERSE REACTIONS
recommended) ACTION (by system)
Antacid Systemic alkalinizer Short-acting, potent GI: Belching, gastric
Adult: PO 0.32 g 14 to correct metabolic systemic antacid. distention, flatulence.
times/d or 1/2 tsp of powder acidosis to minimize Rapidly neutralizes
in glass of water uric acid gastric acid to form Metabolic: Metabolic
Urinary Alkalinizer crystallization sodium chloride, alkalosis; electrolyte
Adult: PO 4 g initially, then associated with carbon dioxide, and imbalance: sodium
12 g q4h uricosuric agents, to water overload (pulmonary
Child: PO 84840 mg/kg/d in increase the edema), hypocalcemia
divided doses solubility of (tetany), hypokalemia,
Cardiac Arrest sulfonamides, and to milk-alkali syndrome,
Adult: IV 1 mEq/kg of a 7.5% enhance renal dehydration.
or 8.4% solution initially, excretion of
then 0.5 mEq/kg q10min barbiturate and other: Rapid IV in
depending on arterial blood salicylate neonates
gas determinations give overdosage. (Hypernatremia,
over 12 min reduction in CSF
Child:IV 0.51 mEq/kg of a pressure, intracranial
4.2% solution q10min hemorrhage).
depending on arterial blood Skin: Severe tissue
gas determinations, give damage following
over 12 min extravasation of IV
Metabolic Acidosis solution.
Adult:IV 25 mEq/kg by IV Urogenital: Renal
infusion over 48 h calculi or crystals,
Infant:IV 23 mEq/kg/d of a impaired kidney
4.2% solution over 48 h function

CONTRAINDICATION/S
Prolonged therapy with sodium
bicarbonate; patients losing
chloride (as from vomiting, GI
suction, diuresis); heart disease,
hypertension; renal
insufficiency; peptic ulcer;
pregnancy (category C).
NURSING RESPONSIBILITIES
(at least 10)
Be aware that long-term use of oral preparation with milk
or calcium can cause milk-alkali syndrome: Anorexia,
nausea, vomiting, headache, mental confusion,
hypercalcemia, hypophosphatemia, soft tissue
calcification, renal and ureteral calculi, renal
insufficiency, metabolic alkalosis.
Lab tests: Urinary alkalinization: Monitor urinary pH as a
guide to dosage (pH testing with nitrazine paper may be
done at intervals throughout the day and dosage
adjustments made accordingly).
Lab tests: Metabolic acidosis: Monitor patient closely by
observations of clinical condition; measurements of acid-
base status (blood pH, Po2, Pco2, Hco3-, and other
electrolytes, are usually made several times daily during
acute period).
Observe for signs of alkalosis (over treatment)
Observe for and report S&S of improvement or reversal of
metabolic acidosis.
Inform the client to not use sodium bicarbonate as
antacid. A non-absorbable OTC alternative for repeated
use is safer.
Patients Name / Room No.