SODIUM BICARBONATE

(NaHCO3; Sodamint; baking soda)

Standard Prescription

sodium bicarbonate __mEq/kg/hr IV infusion

sodium bicarbonate __tabs PO ___(frequency)

Dosages

Metabolic Acidosis Intermittent Infusion:
HCO3 (mmol) = 0.3 x weight (kg) x base deficit (mmol/L).
Administer 1/2 the calculated dose IV over 30 - 60 min and the remaining 1/2 over the next 24 hrs (usual dose is 0.5-2 mmol/kg/hr).

Acidosis of chronic renal failure:
Children: 1-3 mmol/kg/day PO in divided doses Adults: 20-36 mmol/day PO in divided doses.

Renal tubular acidosis (Distal):
Children: 2-3 mmol/kg/day PO in divided doses.
Adults: 0.5-2 mmol/kg/day PO given in 4 to 5 divided doses.

Renal tubular acidosis (Proximal):
Children and adults: 5-10 mmol/kg/day PO in divided doses, and titrate to maintain serum bicarbonate in the normal range.

Urinary Alkalinizer:
0.25-3.3 mmol/kg/dose PO/IV Q6-8H; titrate to desired urinary pH.

Cystic Fibrosis:
325-1300 mg (using 325 mg tablets) per dose PO before meals/snacks with pancreatic enzymes.

Mechanism of Action

Electrolyte supplement.

Forms Supplied

tablet: 325 mg (3.9 mmol) 500 mg (6 mmol).
injection: 8.4% 10 mmol/10 mL PFS, 8.4% 50 mmol/50 mL PFS, 4.2% 5 mmol/10 mL PFS.
injection: 8.4% 50 mmol/50 mL vial.

Components of Arm and Hammer baking soda:
1 tsp (5 mL) provides 4800 mg of sodium bicarbonate = 57 mmol sodium and 57 mmol bicarbonate

Comments

Routine use in cardiac arrest is not recommended.

For metabolic acidosis use only after adequate alveolar ventilation is established.

Use 8.4% concentration for children, 4.2% concentration for neonates and infants.

May be used as an adjuvant to pancreatic enzymes in CF.

1 mmol = 1 mEq Na + and 1 mEq HCO3.

For blocked enteral feeding tubes, use 4 mL of injectable form to dissolve pancreatic enzymes.

See PHSA SHOP for Guidelines for Clearing a Blocked Enteral Feeding Tube.

References

32, 44

Last Edited

2023-05-13 05:18:10