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Urine AlkalinizationAka: Alkaline Diuresis

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  1. See Also
    1. Sodium Bicarbonate
  2. Indication: Drug Overdose with weak acid
    1. Phenobarbital or barbiturate overdose
    2. All Class I antidysrhythmic overdose
      1. Other sodium channel blockers
    3. Tricyclic Antidepressant Overdose
    4. Antihistamine Overdose
    5. Cocaine Overdose
    6. Salicylates
    7. Chlorpropamide
    8. Sulfonamides (some)
    9. Methotrexate
    10. Fluoride
    11. Diflunisal
  3. Mechanism
    1. Enhances urinary excretion of weak acids
    2. Traps weak acids in ionized state (ion trapping)
    3. Prevents reabsorption by renal tubules
  4. Preparation
    1. Sodium Bicarbonate 100 to 150 meq (2-3 ampules)
    2. Dissolve in 1 liter D5W with 20-40 meq KCl
      1. Works out to 0.1 to 0.15 meq/ml
      2. Do not exceed 0.5 meq/ml concentration
  5. Dosing
    1. Use 0.1 to 0.15 meq/l NaHCO3 in D5W with KCl as above
    2. Administer at 2 to 4 times maintenance IV rate
      1. Adult rate will be 200 to 400 ml/hour
      2. Adults would receive 20-30 to 40-60 meq/hour
      3. Do not exceed 1 meq/kg/hour
      4. Typically given over 2-3 hours
    3. Titrate to alkalizization
      1. Keep Urine pH at 7.5 to 8.0
      2. Keep serum pH normal (>7.40)
      3. Keep urine output at 2-5 ml/kg/hour
    4. Monitoring
      1. Follow Serum Potassium closely
      2. Correct Hypokalemia if it occurs
  6. References
    1. (2005) Lexicomp Drug Database, Pocket PC Version
    2. Aaron in Stine (1994) Emergency Med, p.419

Alkaline diuresis (C0419063)

ConceptsTherapeutic or Preventive Procedure (T061)
EnglishAlkaline diuresis
Spanishdiuresis alcalina
Parent ConceptsDiuresis (C0012797)
SourcesSCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)



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