≪ View Page

Differences

This shows you the differences between two versions of the page.

Link to this comparison view

Both sides previous revisionPrevious revision
Next revision		Previous revision
treatment_sodium_bicarbonate [2025/04/13 01:49] – [6.3 Pharmaceutics] jkohtstreatment_sodium_bicarbonate [2025/04/16 04:26] (current) – [2.2 Salicylate Toxicity] jkohts
Line 2: Line 2:
  
 ===== - Overview ===== ===== - Overview =====
 +Sodium bicarbonate (NaHCO₃) is primarily used in toxicology to treat sodium channel blocker toxicity (e.g. TCA toxicity). 
  
- +The patient should then be [[concept_serum_alkalinization|hyperventilated]].
-Sodium Bicarbonate (NaHCO3) is the primary antidote for [[:wikitox:2.1.11.9.2.1_tricyclic_antidepressants|TCA]] poisoning. As these are, by far, the most common cause of cardiac arrest in out of hospital poisonings - patients with drug overdose presenting in cardiac arrest or arresting shortly after arrival should receive a bolus of 1 ampoule of NaHCO<sub>3</sub>. +
- +
-The patient should then be [[:wikitox:alkalinisation|hyperventilated]].+
  
  
Line 33: Line 31:
     * 💊👶 **Sodium bicarbonate 1-2 mmol/kg IV** (i.e. 1-2 mL/kg of 8.4% NaHCO3), as initial dose, then start infusion.     * 💊👶 **Sodium bicarbonate 1-2 mmol/kg IV** (i.e. 1-2 mL/kg of 8.4% NaHCO3), as initial dose, then start infusion.
     * 💊👶 **Sodium bicarbonate 1.5-2× patient's hourly maintenance fluid requirement (weight-based) IV infusion**, then titrate to goal pH.     * 💊👶 **Sodium bicarbonate 1.5-2× patient's hourly maintenance fluid requirement (weight-based) IV infusion**, then titrate to goal pH.
-  * Maintain normokalemia. 
   * Goals:   * Goals:
     * Serum pH 7.5-7.55.     * Serum pH 7.5-7.55.
     * Urinary pH >7.5.     * Urinary pH >7.5.
     * Urine output 2-3 mL/kg/hr.     * Urine output 2-3 mL/kg/hr.
 +    * Maintain normokalemia.
  
  
Line 53: Line 50:
 ===== - Special Populations ===== ===== - Special Populations =====
  
-**Renal impairment:** +**Renal impairment:** Use with caution in patients with severe renal impairment due to the risk of fluid overload and hypernatremia.
- +
-**Hepatic impairment:**+