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Intravenous sodium bicarbonate is contraindicated in patients who are losing chloride, such as by vomiting. [9]Because of its sodium content, intravenous sodium bicarbonate should be used with great care, if at all, in patients with congestive heart failure and severe chronic kidney disease, where low sodium intake is strongly indicated to prevent sodium retention. [9]
People should not be forced to vomit. [2] In those who have a wide QRS complex (> 100 ms) sodium bicarbonate is recommended. [2] If seizures occur benzodiazepines should be given. [2] In those with low blood pressure intravenous fluids and norepinephrine may be used. [1] The use of intravenous lipid emulsion may also be tried. [3]
Treatment may include activated charcoal, intravenous sodium bicarbonate with dextrose and potassium chloride, and dialysis. [2] Giving dextrose may be useful even if the blood sugar is normal. [2] Dialysis is recommended in those with kidney failure, decreased level of consciousness, blood pH less than 7.2, or high blood salicylate levels. [2]
Urinary alkalinization with sodium bicarbonate may be useful for barbiturate poisoning, targeting a urinary pH greater than 7.5 and ensuring urine output surpasses 2 mL/kg/min. [10] If a person is drowsy but awake and can swallow and breathe without difficulty, the treatment can be as simple as monitoring the person closely.
Hyperchloremia is an electrolyte disturbance in which there is an elevated level of chloride ions in the blood. [1] The normal serum range for chloride is 96 to 106 mEq/L, [2] therefore chloride levels at or above 110 mEq/L usually indicate kidney dysfunction as it is a regulator of chloride concentration. [3]
Alkalinizing agents are drugs used to manage disorders associated with low pH. For example, they may be used to treat acidosis due to kidney failure. Used for oral or parenteral therapy, sodium bicarbonate is the commonly preferred alkalinizing agent. [1] Others include potassium citrate, calcium carbonate, sodium lactate and calcium acetate. [2]
Dialysis centers in the United States are rolling out COVID-19 antibody treatments this week, a new path for delivery of Eli Lilly and Regeneron drugs approved for emergency use but facing ...
Hemodialysis, also spelled haemodialysis, or simply dialysis, is a process of filtering the blood of a person whose kidneys are not working normally. This type of dialysis achieves the extracorporeal removal of waste products such as creatinine and urea and free water from the blood when the kidneys are in a state of kidney failure.