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ATENEO DE DAVAO UNIVERSITY

Jacinto St., Davao City
COLLEGE OF NURSING

In Partial Fulfillment of the Requirements

In Nursing Care Management 101

DRUG STUDY
(Sodium bicarbonate)

Submitted by:
Dovenne Jade A. Cania, SN ADDU
Group 1 – 3F

Submitted to;
Vivien Go, RN, MN
Clinical Instructor
September 21, 2009
 DRUG STUDY: SODIUM BICARBONATE

Generic Name: Sodium Bicarbonate Drawing/Picture:

Brand Name: Rhea Sodium Bicarbonate®, Hospira
Sodium Bicarbonate®, Phil Pharmawealth/Atlantic
Sodium Bicarbonate®, United Home Sodium
Bicarbonate®
Classification: Antacids, Antireflux Agents &
Antiulcerants / Electrolytes
Suggested Dose:
 Rhea Sodium Bicarbonate® [tab]
o Adult 325-mg tab 3-6 tab qid. 650-mg
tab 2-4 tab tid.
 Hospira Sodium Bicarbonate® [vial]
o Cardiac arrest Rapid IV
 Adult 200-300 mEq.
 Infant up to 2 yr 4.2% soln. Max: 8 mEq/kg/day.
o Less urgent forms of metabolic acidosis
 Adult & older children Initially 2-5 mEq/kg body wt over 4-8 hr period,
depending upon the severity.
 Phil Pharmawealth/Atlantic Sodium Bicarbonate® [amp]
o IV 10-150 mL given according to degree of hyponatremia.
o Correction of metabolic acidosis Dose depends on the degree of the acid-base
status.
 United Home Sodium Bicarbonate® [tab]
o Adult 650-1300 mg tid. Child 7-12 yr 325-650 mg tid, 2-6 yr 162.5-325 mg tid.
Mode of Action:
Sodium bicarbonate raises blood and urinary pH by dissociation to provide bicarbonate
ions, which neutralizes the hydrogen ion concentration. It also neutralizes gastric acid via
production of carbon dioxide.
 Onset: Oral: Rapid; IV: 15 minutes.
  Duration: Oral: 8-10 minutes; IV: 1-2 hr.
Indications:
Hyperacidity
Sever diarrhea (where there is loss of Sodium Bicarbonate)
Urine Alkalinisation
Management of metabolic acidosis
Dyspepsia
Contraindications:
Metabolic or respiratory alkalosis; hypernatraemia, severe pulmonary edema;
hypocalcaemia, hypochlorhydria.
Drug Interactions:
Amphetamines - ↑ Amphetamine effect by ↑ renal tubular reabsorption
Antidepressants, tricyclic - ↑ TCA effect by ↑ renal tubular reabsorption
Bennzodiazepines - ↓ Benzidiazeine effect R/T ↑ urine alkalinity
Chlorpropamide - ↑ Chlorpropadime excretion rate R/T urine alkalinization
Erythromycin - ↑ Erythromycin effect in urine R/T ↑ urine alkalinization
Ketoconazole - ↓ Ketoconazole effect R/T ↑ urine alkalinization
Quinidine - ↑ Quinidine effects by ↑ renal tubular reabsorption
Tetracycline - ↓ Tetracycline effect R/T ↑ kidney excretion
Side Effects:
Metabolic alkalosis; mood changes, tiredness, shortness of breath, muscle weakness,
irregular heartbeat; muscle hypertonicity, twitching; hypernatraemia, hyperosmolality,
hypocalcaemia, hypokalemia; stomach cramps, flatulence.

Adverse Effects:
Cerebral hemorrhage, CHF (aggravated), Tetany, Pulmonary edema

Nursing Responsibilities:
1.) Hypertonic solutions must be administered by trained personnel. Avoid
extravasations as tissue irritation or cellulites may result.
 2.) Administer isotonic solutions slowly; too rapid administration may result in
death due to cellular acidity. Check rate of flow frequently.
3.) If on low continuous or intermittent NG suctioning or vomiting, assess for
evidence of excessive chloride loss.
4.) Record I&O. observe for dry skin and mucous membranes, polydipsia,
polyuria, and air hunger; may indicate a reversal of metabolic acidosis. With
acidosis, assess for the relief of dyspnea and hyperpnea.
5.) Chew tablets thoroughly and take only as prescribed. Follow with a full glass
of water. Don’t take with milk or yogurt; will fizz up.
6.) Consuming sodium bicarbonate with milk or calcium may result in a milk-
alkali syndrome. Report immediately if anorexia, N&V, or mental confusion
occurs.
7.) If routinely taking excessive PO preparations of sodium bicarbonate to relieve
gastric distress, a rebound reaction may occur, resulting either in an increased
acid secretion or systemic alkalosis. Persistent symptoms of gastric distress
especially with chest pain, SOB, diarrhea or dark tarry BMs require medical
intervention.
8.) Avoid OTC preparations that contain sodium bicarbonate, such as
Alka/Bromo-Seltzer, Gaviscon, or Fizrin.

Bibliography:
Spratto, G. & Woods, A. “Nurse’s Drug Handbook”. Thomson Delmar Learning. 2008
Edition.