SOLUNATE Sodium Bicarbonate 8.4% Solution for IV Injection 20mL 1's
Indications/Uses
In neonates, Sodium Bicarbonate is indicated for: Correction of metabolic acidosis associated with cardiac arrest in patients with pre-existing acidosis; Cardiac arrest associated with hyperkalaemia with pre-existing metabolic; Life threatening hyperkalaemia with pre-existing metabolic.
No benefits have been demonstrated from the routine use of sodium bicarbonate in resuscitation of neonates. In neonates, sodium bicarbonate is recommended in resuscitation only in cases of prolonged cardiac arrest, irresponsive to other therapy, after establishment of adequate ventilation and circulation.
Dosage/Direction for Use
Administration is via slow intravenous injection.
For intravenous administration only.
Adults: The usual dose is 1 mmol/kg (1 mL/kg 8.4% solution) followed by 0.5 mmol/kg (0.5 mL/kg 8.4% solution) given at 10 minute intervals.
Children: The usual dose is 1 mmol/kg by slow IV injection. (1 mL/kg 8.4% solution).
In premature infants and neonates, the 4.2% solution should be used or 8% solution should be diluted 1:1 with 5% dextrose.
Overdosage
Contraindications
Special Precautions
Accidental extravascular injection of hypertonic solutions may cause vascular irritation or sloughing. The use of scalp veins should be avoided.
Whenever respiratory acidosis is concomitant with metabolic acidosis, both pulmonary ventilation and perfusion must be adequately supported to get rid of excess CO2.
Use In Pregnancy & Lactation
Patients requiring i.v. sodium bicarbonate are unlikely to be fit enough to breast feed.
Adverse Reactions
Cardiac Disorder: Deterioration of hemodynamic status associated with volume overload.
Nervous System Disorders: Intracranial hemorrhage (in neonates), hyperirritability or tetany.
General Disorders and Administration Site Conditions: Extravasation. Incorrect administration (intra-arterial, pa ravenous) may cause tissue necrosis.
Drug Interactions
Urinary alkalinisation will increase the renal clearance of medicinal products which are acid in nature e.g. tetracyclines, especially doxycycline, acetylsalicylic acid, chlorpropamide, lithium, methenamine. It increases the half-life and duration of action of basic drugs such as quinidine, amphetamines, ephedrine, pseudoephedrine, memantine and flecainide. Sodium bicarbonate is known to increase renal tubular reabsorption of mecamylamine causing hypotension.
Hypochloraemic alkalosis may occur if sodium bicarbonate is used in conjunction with potassium depleting diuretics such as bumetanide, ethacrynic acid, furosemide and thiazides. Concurrent use in patients taking potassium supplements may reduce serum potassium concentration by promoting an intracellular ion shift.
Action
Pharmacokinetics: Sodium bicarbonate is eliminated principally in the urine and effectively alkalises it.
MedsGo Class
Features
- Bicarbonate