Shandong Sino Pharmaceutical Technology Co., Ltd.

Sodium Bicarbonate Injection is a commonly used alkaline drug in clinical practice. It is mainly used to correct metabolic acidosis and alkalize urine. It can also be used to rescue patients with excessive stomach acid and poisoning from certain drugs.

Pharmacological effects and indications
1. Core pharmacology
Correcting acidosis: Sodium bicarbonate dissociates into Na and HCO. HCO combines with H to form H2CO3, which then decomposes into CO2 and H2O, reducing the concentration of H in the body and correcting metabolic acidosis.
Alkalizing urine: Increasing the pH value of urine increases the dissociation degree of acidic drugs (such as sulfonamides and barbiturates), reduces the reabsorption of renal tubules, and accelerates excretion.
Neutralizing stomach acid: Directly neutralizes stomach acid (HCl), alleviating discomfort caused by excessive stomach acid (mainly oral preparations, with less use of injections).

2. Indications

Metabolic acidosis: such as severe diarrhea, renal failure, diabetic ketoacidosis (DKA), and acidosis after cardiopulmonary resuscitation;
Alkalizing urine: Preventing sulfonamide drug crystallization urine and promoting uric acid excretion (as an adjunctive treatment for acute gout attacks);
Drug poisoning rescue: Barbiturate and salicylic acid drug poisoning (combined with fluid replacement and diuresis);
Others: Hyperkalemia (promoting K entry into cells), excessive stomach acid (oral/intravenous temporary use).

Key Points of Clinical Medication
Dosage and Administration (Individualized adjustment required)

For metabolic acidosis (mild), 5ml/kg of intravenous infusion (1.4% isoexudate) should be administered, adjusted according to blood gas analysis

Metabolic acidosis (severe) : Intravenous push/drip (5% hypertonic fluid) 1-2 ml/kg, rate ≤5ml/min (avoid hypernatremia)

Intravenous drip of alkalized urine (diluted 5% solution to 1.4%) 500 to 1000ml daily to maintain urine pH 6.5 to 7.5

For hyperkalemia, intravenous injection (5% solution) of 50 to 100ml, rapid injection (5 to 10 minutes), combined with insulin and glucose

2. Contraindications and Use with caution
Contraindications: Those allergic to sodium bicarbonate, severe metabolic alkalosis, hypernatremia, hypokalemia (aggravated hypokalemia after alkalization), oliguria/anuria;
Use with caution: Heart failure (increased sodium load aggravates heart failure), renal failure (decreased sodium excretion capacity), pregnancy-induced hypertension syndrome (edema caused by high sodium).

3. Adverse reactions
In the short term, rapid infusion can lead to hypernatremia, hypokalemia, metabolic alkalosis and arrhythmia. Local venous stimulation (extravasation can cause tissue edema);
Long-term: Hypokalemia, reduced calcium absorption (inducing hypocalcemic convulsions), sodium retention (edema, hypertension).

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