Hyperosmolar sodium bicarbonate solutions are widely used in clinical toxicology both as an antidote to drugs that impair fast sodium channel function and as an alkalinising agent to manipulate drug distribution and excretion (salicylate and phenobarbitone). It is also used in profound metabolic acidosis with cyanide, isoniazid and toxic alcohol toxicity.
A 25 year-old male (70 kg) is brought in by ambulance 30 to 60 minutes after ingesting 70 x 50mg amitriptyline. He is tachycardic (HR 120) with an otherwise 'normal' ECG (QRS 95 ms) but is becoming drowsy. You are called to the resuscitation room to assess him.
Sodium Bicarbonate and Diabetic Ketoacidosis. The correction of the acidaemia in DKA is achieved by correcting the underlying pathophysiology with fluid replacement and insulin
Sodium Bicarbonate Use. metabolic acidosis leads to adverse cardiovascular effects. bicarbonate must be administered in a solution as sodium bicarbonate
A 72 year old female is admitted following an emergency abdominal aortic aneurysm repair. Explain the biochemical results and brown urine