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Sodium bicarbonate injection

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Sodium bicarbonate injection
Sodium bicarbonate injection
Detail

【Indications】

(1) Treatment of metabolic acidosis. To treat mild to moderate metabolic acidosis, oral administration is appropriate. Severe metabolic acidosis should be given intravenously, such as severe kidney disease, circulatory failure, cardiopulmonary resuscitation, cardiopulmonary bypass, and severe primary lactic acidosis, diabetes, ketoacidosis, etc.

(2) Alkalizing urine. For the prevention of uric acid kidney stones, reduce the nephrotoxicity of sulfa drugs and acute hemolysis to prevent hemoglobin from depositing in the renal tubules.

(3) As an antacid to treat symptoms caused by hyperacidity.

(4) Intravenous drip has a non-specific therapeutic effect on certain drug poisoning. Such as barbiturates, salicylic acid drugs and methanol poisoning. However, this product is forbidden for gastric lavage when swallowing strong acidosis. Because this product reacts with strong acid to produce a large amount of carbon dioxide, it causes acute gastric dilation and even stomach rupture.

【Specifications】 250ml:12.5g

【Dosage】

(1) Alkalizing urine: intravenous drip, 2-5mmol/kg, drip in 4-8 hours.

(2) Metabolic acidosis, intravenous infusion, the required dose is calculated by the following formula: the amount of alkali supplement (mmol) = (×2.3-the actual measured BE value) × 0.25 × body weight (kg) or the amount of alkali supplement ( mmol) = normal CO2CP-actual measured CO2CP (mmol) × 0.25 × body weight (kg). Unless there is a loss of bicarbonate in the body, generally give 1/3-1/2 of the calculated dose first, and the instillation is completed within 4-8 hours. During cardiopulmonary resuscitation, the first time is 1mmol/kg, and then the dosage will be adjusted according to the results of blood gas analysis (1g sodium bicarbonate is equivalent to 12mmol bicarbonate). Intravenous medication should also pay attention to the following issues. ① The concentration range for intravenous application is 1.5% (isotonic) to 8.4%; ② Start with a small dose, and determine the additional dose based on changes in blood pH and bicarbonate concentration; ③ A large amount of intravenous infusion in a short time can cause severe alkalosis , Hypokalemia, hypocalcemia. When the dosage exceeds 10 ml of hypertonic solution per minute, it can cause hypernatremia, cerebrospinal fluid pressure drop and even intracranial hemorrhage, which is more likely to occur in newborns and children under 2 years old. Therefore, when infusing with a 5% solution, the speed cannot exceed 8 mmol sodium per minute. However, due to fatal acidosis during cardiopulmonary resuscitation, rapid intravenous infusion should be used.

【Adverse reactions】

(1) Arrhythmia, muscle cramps, pain, abnormal fatigue, weakness, etc. may occur during large injections, mainly due to hypokalemia caused by metabolic alkalosis.

(2) When the dose is too large or there is renal insufficiency, edema, mental symptoms, muscle pain or convulsions, slow breathing, odor in the mouth, abnormal fatigue and weakness may occur. Mainly caused by metabolic alkalosis.

(3) Long-term application can cause frequent urination, urgency, persistent headache, loss of appetite, nausea and vomiting, abnormal fatigue and weakness.

【Contraindications】

  This product is forbidden for gastric lavage when swallowing strong acidosis. Because this product reacts with strong acid to produce a large amount of carbon dioxide, it can cause acute gastric dilation and even stomach rupture.

【Precautions】

(1) Interference with diagnosis: It has obvious influence on the results of gastric acid secretion test or blood and urine pH measurement.

(2) Use with caution in the following situations: ① Oliguria or anuria, because it can increase sodium load; ② When sodium retention and edema, such as liver cirrhosis, congestive heart failure, renal insufficiency, pregnancy-induced hypertension; Hypertension may aggravate the condition due to increased sodium load.

(3) Do not use intravenous medication for the following conditions: ① Metabolic or respiratory alkalosis. ② A large amount of chlorine is lost due to vomiting or continuous gastrointestinal negative pressure suction, and metabolic alkalosis is very likely to occur. ③ In hypocalcemia, alkalosis caused by this product can aggravate the manifestations of hypocalcemia.

[Medicine for pregnant and lactating women]

(1) Long-term or large-scale application can cause metabolic alkalosis, and excessive sodium load can cause edema. Pregnant women should use it with caution.

(2) This product can be secreted by breast milk, but there is no relevant data on its effect on infants.

【Children's Medication】

  For treatment of acidosis, refer to adult dosage. During cardiopulmonary resuscitation, the first intravenous injection is based on body weight 1mmol/kg, and the dosage will be adjusted according to the results of blood gas analysis.

[Medication for the elderly] Unclear.

【medicine interactions】

(1) When adrenal cortex hormones (especially those with strong mineralocorticoid effects), corticotropin, androgen are used in combination, hypernatremia and edema are prone to occur.

(2) When combined with amphetamine and quinidine, the renal excretion of the latter two is reduced and toxic effects are likely to occur.

(3) When combined with anticoagulants such as warfarin and M cholinesterase, the absorption of the latter is reduced.

(4) Combined use with calcium-containing drugs, milk and dairy products can cause milk-alkali syndrome.

(5) When combined with H2 receptor antagonists such as cimetidine and ranitidine, the absorption of the latter decreases.

(6) Combined with potassium excretion diuretics, it increases the risk of hypochloric alkalosis.

(7) This product can alkalinize urine and affect the excretion of ephedrine by the kidneys, so the dose of ephedrine should be reduced when combined.

(8) To reduce the absorption of oral iron, the two drugs should be taken as far apart as possible.

(9) Increase the oral absorption of levodopa.

(10) The increase in sodium load increases the excretion of lithium by the kidneys, so when combined with lithium preparations, the dosage of lithium preparations should be adjusted as appropriate.

(11) Alkalizing urine can inhibit the conversion of urotropine into formaldehyde, thereby inhibiting the therapeutic effect of the latter, so the combination of the two drugs is not recommended.

(12) The alkalization of urine by this product can increase the excretion of salicylic acid by the kidneys.

【Overdose】

(1) The concentration range for intravenous application is 1.5% (isotonic) to 8.4%;

(2) Start with a small dose, and determine the additional dose based on changes in blood pH and bicarbonate concentration;

(3) Large amounts of intravenous infusion in a short period of time can cause severe alkalosis, hypokalemia and hypocalcemia. When the dosage exceeds 10ml of hypertonic solution per minute, it can cause hypernatremia, cerebrospinal fluid pressure drop and even intracranial hemorrhage. This is more likely to occur in newborns and children under 2 years old, so the rate of intravenous injection should not exceed 8 mmol sodium. However, during cardiopulmonary resuscitation, rapid intravenous infusion is required due to fatal acidosis.

【Pharmacology and Toxicology】

(1) Treatment of metabolic acidosis. This product increases the concentration of carbonate in plasma, neutralizes hydrogen ions, thereby correcting acidosis;

(2) Urine is alkalized. As the pH value increases after the carbonate concentration in the urine increases, it is difficult for uric acid, sulfa drugs and hemoglobin to form crystals or aggregates in the urine;

(3) Sulfuric acid, oral administration can quickly neutralize or buffer gastric acid without directly affecting gastric acid secretion. Therefore, the pH in the stomach rises rapidly to relieve the symptoms caused by high gastric acid.

【Pharmacokinetics】

  This product enters the blood circulation directly after intravenous drip. Sodium bicarbonate in the blood is filtered by the glomerulus and excreted in the urine. Part of bicarbonate ions combine with hydrogen ions in urine to form carbonic acid, which is then decomposed into carbon dioxide and water. The former can diffuse into renal tubular cells, combine with intracellular water to produce carbonic acid, and the dissociated bicarbonate ions are reabsorbed into the blood circulation. The bicarbonate ion in the blood combines with the hydrogen ion in the blood to produce carbonic acid, which is then decomposed into carbon dioxide and water, the former is exhaled through the lungs.

【Storage】 Keep tightly closed.

[Packing] Neutral borosilicate glass infusion bottle 250ml×30 bottles/carton

【Validity Period】 24 months

[Executive standard] "Chinese Pharmacopoeia" 2015 edition two

[Approval Number] National Medicine Standard H52020416

[Manufacturer] Company name: Guizhou Tiandi Pharmaceutical Co., Ltd.




Personnel department: 0859-3338239

Email: tdyy@gztiandi.com

Address: Qianxinan Buyi and Miao Autonomous Prefecture, Guizhou Province No.6, Baokang Road, Yilong Hongxing Pharmaceutical Industrial Park

@copyright 2017 Guizhou Tiandi Pharmaceutical Co., Ltd.

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