Sodium Bicarbonate
Information from Plumb's Veterinary Drug Handbook, 7th Edition, by Donald C. Plumb:
Sodium bicarbonate is indicated to treat metabolic acidosis and alkalinize the urine. It is also used as an adjuctive therapy in treating hypercalcemic or hyperkalemic crises. Bicarbonate ions are the conjugate base component of bicarbonate: carbonic acid buffer, the principle extracellular buffer in the body.
Contraindications: Considered generally contraindicated in patients with metabolic or respiratory alkalosis, excessive chloride loss secondary to vomiting or GI suction, at risk for development of diuretic-induced hypochloremic acidoses, or with hypocalcemia where alkalosis may induce tetany. Use with extreme caution and give very slowly in patients with hypocalcemia. Because of the potential sodium load, use in caution with patients with CHF, nephrotic syndrome, hypertension, oliguria, or volume overload.
Adverse effects: Can lead to metabolic alkalosis, hypokalemia, hypocalcemia, overshoot alkalosis, hypernatremia, volume overload, CHF, shifts in the oxygen dissociation curve causing decreased tissue oxygenation, and paradoxical CNS acidosis leading to respiratory arrest. If used during cardiopulmonary resuscitation, hypercapnia may result if the patient is not well ventilated; and patients may be predisposed to ventricular fibrillation. Can cause severe alkalosis with irritability or tetany if overdosed or given rapidly.
The following drugs may interact with Sodium bicarbonate: anticholinergic agents, azole antifungals, ciprofloxacin, enrofloxacin, corticosteroids, diuretics, ephedrine, histamine blocking agents, iron products, oral medications, quinidine, salicylates, sucralfate, tetracyclines.
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