Sodium Bicarbonate Infant Injection

Generic name: Sodium Bicarbonate

Drug class: Antacids, Minerals and Electrolytes, Urinary pH Modifiers

Dosage form: Injection, Solution

Route of administration: Intravenous

Dose: For infants up to two years of age, the recommended intravenous dose is up to 8 mEq/kg/day. In emergency situations like cardiac arrest, a rapid intravenous dose of 200 to 300 mEq may be administered initially, with continued doses as needed, guided by arterial pH and blood gas monitoring.

Mechanism of action: Sodium bicarbonate dissociates in water to provide sodium (Na⁺) and bicarbonate (HCO₃⁻) ions. Bicarbonate acts as a buffer, neutralizing excess hydrogen ions (H⁺) in the blood, thereby increasing blood pH and correcting metabolic acidosis.

Drug usage cases:

• Treatment of metabolic acidosis
• Management of certain drug overdoses
• Alkalinization of urine to enhance the excretion of acidic drugs
• Correction of acidosis during cardiopulmonary resuscitation

Drug contraindications:

• Hypersensitivity to sodium bicarbonate
• Metabolic or respiratory alkalosis
• Severe renal impairment (e.g., anuria)
• Congestive heart failure with significant edema

Side effects:

• Metabolic alkalosis
• Hypernatremia
• Hypokalemia
• Edema
• Intracranial hemorrhage (in neonates and infants)
• Cardiac arrhythmias
• Hypocalcemia leading to tetany

Warnings:

• Use with caution in patients with congestive heart failure, severe renal insufficiency, or conditions leading to sodium retention.
• Rapid intravenous administration in neonates and infants may cause hypernatremia, decreased cerebrospinal fluid pressure, and potential intracranial hemorrhage. Administration should be limited to no more than 8 mEq/kg/day, with slow infusion rates preferred.
• Monitor serum electrolytes, blood pH, and total CO₂ content during therapy to avoid overcorrection and alkalosis.
• Avoid extravasation to prevent tissue necrosis and ischemia.
• Incompatibility with calcium-containing solutions; precipitation may occur if mixed.

Use during pregnancy or breastfeeding:

Animal reproduction studies have not been conducted with sodium bicarbonate. It is also not known whether sodium bicarbonate can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Sodium bicarbonate should be given to a pregnant woman only if clearly needed.