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Sodium Bicarbonate: Difference between revisions

From Pharmacopedia
[unchecked revision][unchecked revision]
home-claude punt-list stub-split, Top 300 #227
 
home-claude house-rule fix (terminology / spelling)
 
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| pregnancy        = Routine antacid and acidosis correction acceptable
| pregnancy        = Routine antacid and acidosis correction acceptable
| legal            = [[USLegal:Prescription only|Rx-only]] for IV formulations; OTC for oral
| legal            = [[USLegal:Prescription only|Rx-only]] for IV formulations; OTC for oral
| mechanism        = <vote slug="nahco3-mech-claim">Sodium bicarbonate raises serum pH directly via the carbonic acid / bicarbonate buffer system; in TCA overdose its benefit is partly pH-driven (reducing free drug) and partly sodium-driven (overcoming TCA sodium-channel blockade), which is why hypertonic 8.4% is preferred over isotonic.</vote> Bicarbonate is not benign: high-volume use produces hypernatremia, metabolic alkalosis, hypokalemia, and (in arrest) paradoxical intracellular acidosis<ref name="nahco3-label" />.
| mechanism        = <vote slug="nahco3-mech-claim">Sodium bicarbonate raises serum pH directly via the carbonic acid / bicarbonate buffer system; in TCA overdose its benefit is partly pH-driven (reducing the free unbound fraction) and partly sodium-driven (overcoming TCA sodium-channel blockade), which is why hypertonic 8.4% is preferred over isotonic.</vote> Bicarbonate is not benign: high-volume use produces hypernatremia, metabolic alkalosis, hypokalemia, and (in arrest) paradoxical intracellular acidosis<ref name="nahco3-label" />.
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== References ==
== References ==
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