Sodium Bicarbonate With Acid

Sodium bicarbonate with acid

Specification

Adding sodium bicarbonate to water can prepare a solution with specific pH adjustment ability, which may have benefits in terms of health, hydration, and exercise performance, but attention should be paid to its safety and compatibility.

Application

When NaHCO3 reacts with an acid (such as acetic acid, the main component of vinegar), it produces carbon dioxide gas, water, and sodium acetate.

Dosage Forms and Strengths

Lactic acidosis: Using NaHCO3 remains controversial but is an option if pH is below 7.

Diabetic ketoacidosis: The use of NaHCO3 remains controversial in diabetic ketoacidosis since recovery outcomes are similar with or without NaHCO3. However, if the pH is below 7 after 1 hour of fluid administration, sodium bicarbonate is still recommended. Sodium bicarbonate should be given in hypotonic fluid every 2 hours until pH is 7 or higher.

Salicylate overdose: 1 to 2 mEq/kg/dose IV for a single dose

Hyperkalemia: When patients with severe hyperkalemia (serum potassium level of more than 6 mEq/L or more than 5.5 mEq/L with arrhythmia or EKG changes) have metabolic acidosis, NaHCO3 should be administered. The dose needed is empirical and unpredictable. Initially, 150 mEq of sodium bicarbonate can be given in 1 liter of 5% dextrose over 4 hours. More can be provided if acidosis is not corrected with this regimen. If there is a need to decrease serum potassium emergently, 50 mEq of NaHCO3 IV can be given over 5 minutes, followed by other methods of potassium reduction.

Urinary alkalinization: 975 to 1950 mg orally every 4 hours, starting with 3900 mg orally for a single dose

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