Sodium Bicarbonate

Sodium Bicarbonate Functional Class

Electrolyte, alkalinizing agent

Sodium Bicarbonate Mechanism of Action

Sodium bicarbonate dissociates to provide bicarbonate ions which neutralize hydrogen ion concentration and raises blood and urinary pH.

Sodium Bicarbonate Indications

Cardiac arrest with suspected hyperkalemia or acidosis, tricyclic antidepressant overdose

Sodium Bicarbonate Contraindications

None in the emergency setting

Sodium Bicarbonate Precautions/Warnings

Not recommended for routine use in cardiac arrest. Vesicant, can cause tissue necrosis with extravasation.

Sodium Bicarbonate Adverse Reactions

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 left shift of the oxyhemoglobin curve which may inhibit oxygen release to tissues and induce malignant arrhythmias.

Sodium Bicarbonate Drug Interactions

Will deactivate most catecholamines and vasopressors. Sodium bicarbonate will precipitate when used in conjunction with calcium chloride. Sodium bicarbonate should run on its own line and/or IV line flushed with saline between boluses.

Sodium Bicarbonate Dosage and Route

2 mEq/kg IV/IO

Sodium Bicarbonate Pharmacokinetics

Onset: 2-10 minutes
Duration: 30-60 minutes
Half-life: Unknown