Mindanao State University – Iligan Institute of Technology Student: _________________________ Block:___________

COLLEGE OF NURSING

PHARMACOLOGICAL MANAGEMENT

DRUG STUDY

Brand Name: ____________Not Indicated______________ Generic Name: __Sodium Bicarbonate___ Drug Classification: __Alkanizers______

Dosage, Route & Frequency Drug-Drug & Drug- Side Effects Adverse Reactions
Drug Action Indications Contraindications
Recommended Prescribed Food Interactions (By System) (By System)
Metabolic acidosis Sodium bicarbonate Drug Interactions:  Metabolic  Metabolic or Metabolic  Metabolic alkalosis
Adults and raises blood and Increases toxicity of respiratory - Metabolic side effects have  mood changes,
acidosis
children: Dosage urinary pH by amphetamines, alkalosis; included metabolic alkalosis,
 Urinary  tiredness,
dissociation to provide
depends on blood ephedrine, hypernatraemia, hypernatremia/hyperosmolarity,  shortness of
bicarbonate ions, which Alkalinization
carbon dioxide neutralizes the pseudoephedrine, severe hypochloremia, and hypokalemia. breath,
content, pH, and flecainide, quinidine  Antacid pulmonary These effects have been
hydrogen ion  muscle weakness,
patient’s condition; concentration. and quinine.  Cardiac arrest oedema; associated with rapid or prolonged  irregular heartbeat
Usually, 2 to 5 Decreases effects of  Prevention of hypocalcaemia, administration
Pharmacokinetics:  muscle
mEq/kg IV infused lithium, contrast media hypochlorhydria. Respiratory
Absorption: IV: 15 - hypertonicity,
over 4- to 8-hour chlorpropamide and - The respiratory drive may be
30 minutes. nephrotoxicity  twitching,
period. salicylates due to  Pregnancy suppressed after bicarbonate
Excretion: Excreted in  Hyperkalemia  tetany;
increased clearance. administration due to increased
the urine.  hypernatraemia,
Usual Adult Dose May affect the venous C02 concentration. Without
Half-life: I.V: 1 to 2
for Hyperkalemia: absorption of certain adequate ventilation, worsened  hyperosmolality,
hours.
One ampule of 7.5% drugs due to raised systemic acidosis could develop  hypocalcaemia,
sodium bicarbonate intra-gastric pH. Nervous system  hypokalaemia;
(44.6 mEq HCO3 - Nervous system side effects have  stomach cramps,
ion) may be included irritability, tetany, mental  flatulence
administered slowly stupor, coma, and intraventricular  Tissue necrosis at
IV over 5 minutes hemorrhage. inj site
and repeated at 10 Local
to 15 minute - Local side effects have included
intervals if ECG IV site pain, venous irritation, and
changes persist extravasation.  Cellulitis, tissue
necrosis, ulceration, or skin
sloughing have possibly been the
result of extravasation
Cardiovascular
- Cardiovascular side effects have
 included decreased cardiac
contractility possibly resulting from
infusion of sodium bicarbonate in
patients with severe acidosis
Gastrointestinal
- Gastrointestinal side effects
associated with oral administration
have rarely included gastric

rupture
Renal

- Urinary alkalinization from

bicarbonate can cause a falsely
positive colorimetric assay for
protein

Responsibilities in the Nursing Process (ADPIE) Responsibilities in the Nursing Process (ADPIE)
Assessment ■ Monitor electrolytes and urinary pH, calcium, and phosphate levels.
■ Evaluate patient’s pain, including type, duration, severity, and frequency. Patient Teaching (General)
■ Check patient’s renal function. ■ Teach patient to report pain, coughing, or vomiting of blood.
■ Assess for fluid and electrolyte imbalances, especially serum phosphate and calcium ■ Encourage patient to drink 2 oz of water after antacid to ensure that drug reaches stomach.
levels ■ Direct patient to take antacid 1 to 3 hours after meals and at bedtime. Instruct patient not to take antacids
■ Obtain drug history; report probable drug-drug interactions. at mealtime; they slow gastric emptying time, causing increased GI activity and gastric secretions.
■ Advise patient to notify health care provider if constipation or diarrhea occurs; the antacid may have to be
Nursing Diagnoses changed. Self-treatment should be avoided.
■ Acute pain related to repeated spicy food and alcohol ingestion ■ Warn that taking an unlimited amount of the antacid is contraindicated.
■ Ineffective health maintenance related to misuse of antacids ■ Warn patient to avoid taking antacids with milk or foods high in vitamin D.
■ Deficient knowledge related to misinterpretation of information ■ Advise patient to avoid taking antacids within 1 to 2 hours of other oral medications, because they may
interfere with absorption.
Planning
■ Patient’s abdominal pain will decrease after 1 to 2 weeks of antiulcer drug
management.
Nursing Interventions
■ Avoid administering antacids with other oral drugs, because antacids can delay their
absorption. Do not give an antacid with tetracycline, digoxin, or quinidine, because it
binds with and inactivates most of the drug. Antacids are given 1 to 2 hours after other
medications.
■ Shake suspension well before administering; follow with water