Na HCO3

Name
Diagnosis
Doctor
DRUG DATA
Generic Name:
Sodium Bicarbonate
Trade Name:
Baking Soda, Bell-Ans,
Citrocarbonate
Patients Dose:
500 mg1 tab TID
Ricarda, Andoy
Age
71 y.o.
Height
51
Anemia secondary to CKD secondary to obstructive uropathy

DM II - Uncontrolled
Dr. Francis Nino Canedo, MD
Sex
Female
Weight
54 kg
Date of Admission
January 24, 2016
Body Build
asthenic
CLASSIFICATION
Pharmacologic class:
alkalinizing agents
Therapeutic class:
antiulcer agents
Pregnancy risk
category:
C
MECHANISM OF ACTION
Action:
Acts as an alkalinizing agent by
releasing bicarbonate ions.
Following oral administration,
releases bicarbonate, which is
capable of neutralizing gastric
acid. Therapeutic
Effects:Alkalinization.
Neutralization of gastric acid.
INDICATION
General Indication:
Management of metabolic
acidosis. Used to alkalinize urine
and promote excretion of certain
drugs in overdosage situations
(phenobarbital, aspirin). Antacid,
Unlabeled Uses: Stabilization of
acid-base status in cardiac arrest
and treatment of life-threatening
hyperkalemia.
PHARMACOKINETICS
Minimum Dose:
325 mg OD.
Absorption: Following oral

administration, excess
bicarbonate is absorbed and
results in metabolic alkalosis and
alkaline urine.
Distribution: Widely distributed
into extracellular fluid.
Metabolism and Excretion:
Sodium and bicarbonate are
excreted by the kidneys.
Half-life: Unknown.
Maximum Dose:
325 mg q6hrs
Availability:
OTC; Tablets 325 mg (3.9
mEq Na/tablet)OTC, 500
mg (6.0 mEq
Na/tabletOTC, 520 mg (6.2
mEq Na/tablet)OTC, 650
mg (7.7 mEq Na/tablet)
Contraindicated in: Metabolic or

respiratory alkalosis;
Hypocalcemia; Hypernatremia;
Excessive chloride loss; As an
antidote following ingestion of
strong mineral acids; Patients on
sodium-restricted diets (oral use
as an antacid only);Renal failure
(oral use as an antacid
only);Severe abdominal pain of
unknown cause, especially if
associated with fever (oral use as
an antacid only).
Use Cautiously in: HF; Renal
insufficiency; Concurrent
corticosteroid therapy; Chronic use
as an antacid (may cause
metabolic alkalosis and possible
sodium overload); Pedi: May risk
of cerebral edema in children with
diabetic ketoacidosis.
Route Onset
Peak
Duration
P.O. immediate 30 mins 1-3hrs
Route:
PO
Source:
Daviss Drug Guide for
Nurses 14th Edition. A. H.
Vallerand, C. A. Sanoski,
with J. H. Deglin. F.A.
Davis Company
1915ArchStreet
Philadelphia, PA 19103
PatientsIndication:
Management of metabolic
acidosis/neutralizing gastric acid.
CONTRAINDICATION
Source:
Daviss Drug Guide for
Nurses 14th Edition. A. H.
Vallerand, C. A. Sanoski,
with J. H. Deglin. F.A.
Davis Company
1915ArchStreet
Source:
Daviss Drug Guide for Nurses
14th Edition. A. H. Vallerand, C. A.
Sanoski, with J. H. Deglin. F.A.
Davis Company 1915ArchStreet
Source:
Daviss Drug Guide for Nurses 14th
Edition. A. H. Vallerand, C. A.
Source:
ADVERSE EFFECTS and SIDE

EFFECTS
CV: edema.
GI: POflatulence, gastric
distention.
F and E: metabolic alkalosis,
hypernatremia, hypocalcemia,
hypokalemia, sodium and water
retention.
Local: irritation at IV site.
Neuro: tetany, cerebral
hemorrhage (with rapid injection in
infants).
NURSING RESPONSIBILITIES
Before:
-Check for doctors order
-Consider 10 rights of drug administration
-Check clients medications, make sure none of them
interact with drug
- Assess patient for epigastric or abdominal pain and
frank or occult blood in the stool, emesis, or gastric
aspirate.
- Lab Test Considerations: Monitor serum sodium,
potassium, calcium, bicarbonate concentrations,
serum osmolarity, acid-base balance, and renal
function prior to and periodically throughout therapy.
INTERACTIONS
Drug-Drug: Following oral
administration, may absorption of
ketoconazole. Concurrent use with
calcium-containing antacids may
lead to milk-alkali syndrome.
Urinary alkalinization may result in
salicylate or barbiturate blood
levels; blood levels of quinidine,
mexiletine,flecainide, or
amphetamines; risk of
crystalluria from fluoroquinolones;
effectiveness of methenamine.
May negate the protective effects
of enteric-coated products (do not
administer within 12 hr of each
other).
Source:
During:
-This medication may cause premature dissolution of
enteric-coated tablets in the stomach.
-Tablets must be taken with a full glass of water.
-Advise patient not to take milk products concurrently
with this medication. Renal calculi or hypercalcemia
(milk-alkali syndrome) may result
After:
-Instruct patient to take medication as directed. Take
missed doses as soon as remembered unless almost
time for next dose.
-Review symptoms of electrolyte imbalance with
patients on chronic therapy; instruct patient to notify
health care professional if these symptoms occur.
-Advise patient to avoid routine use of sodium
bicarbonate for indigestion.
- Dyspepsia that persists >2 wk should be evaluated
by a health care professional.
- Advise patient on sodium-restricted diet to avoid use
of baking soda as a home remedy for indigestion.
- Instruct patient to notify health care professional if
indigestion is accompanied by chest pain, difficulty
breathing, or diaphoresis or if stools become dark and
tarry.
Source:
Daviss Drug Guide for Nurses 14th Edition. A. H.
Vallerand, C. A. Sanoski, with J. H. Deglin. F.A. Davis
Company 1915ArchStreet Philadelphia, PA 19103

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Name

Anemia secondary to CKD secondary to obstructive uropathy

January 24, 2016

Absorption: Following oral

Contraindicated in: Metabolic or

ADVERSE EFFECTS and SIDE

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