Sodium Bicarbonate 7.5% (Canada)

Company: P.V.L.

“Veterinary Pharmaceuticals for the Professional”

Sterile Solution 7.5% (89.2 mEq. each 100 cc.)

FOR VETERINARY USE ONLY

DIN 00345326

Description

Sodium Bicarbonate 7.5% Solution is a sterile, nonpyrogenic preparation of sodium bicarbonate (NaHCO₃) U.S.P., in water for injection. Each 100 cc vial contains 7.5 g. of sodium bicarbonate (89.2 mEq. of bicarbonate, 0.89 mEq/ml.). The solution is hypertonic and has an approximate pH of 7.8. Air in the vial is displaced by inert gas.

ACTIONS: Sodium bicarbonate has a valuable role in the treatment of metabolic acidosis due to a wide variety of causes. Sodium bicarbonate therapy increases plasma bicarbonate, buffers excess hydrogen ion concentration, raises blood pH and reverses the clinical manifestations of acidosis.

Sodium Bicarbonate 7.5% Indications

Sodium Bicarbonate 7.5% Solution is indicated in the treatment of metabolic acidosis which may occur in severe renal disease, uncontrolled diabetes, circulatory insufficiency due to shock or severe dehydration, cardiac arrest and severe primary lactic acidosis. Sodium bicarbonate is further indicated in the treatment of barbiturate toxicity. Sodium bicarbonate also is indicated in severe diarrhea which is often accompanied by a significant loss of bicarbonate.

The treatment of metabolic acidosis should, if possible, be superimposed on measures designed to control the basic cause of the acidosis - e.g., insulin in uncomplicated diabetes, blood volume restoration in shock. But since an appreciable time interval may elapse before all of the ancillary effects are brought about, bicarbonate therapy is indicated to minimize risks inherent to the acidosis itself.

Vigorous bicarbonate therapy is required in any form of metabolic acidosis where a rapid increase in plasma total CO₂ content is crucial - e.g., cardiac arrest, circulatory insufficiency due to shock or severe dehydration, and in severe primary lactic acidosis or severe diabetic acidosis.

Contraindications

Sodium Bicarbonate is contraindicated in animals who are losing chloride by vomiting and in animals receiving diuretics known to produce a hypochloremic alkalosis.

Precautions

The aim of all Bicarbonate therapy is to produce a substantial correction of the low total CO₂ content and blood pH, but the risks of overdosage and alkalosis should be avoided. Hence, repeated fractional doses and periodic monitoring by appropriate laboratory tests are recommended to minimize the possibility of overdosage.

The potentially large loads of sodium given with bicarbonate require that caution be exercised in the use of Sodium Bicarbonate in animals with congestive heart failure or other edematous or sodium-retaining states, as well as in animals with oliguria or anuria. Each 100 cc vial contains 2.052 g. (20.5 mg./ml.) of sodium (Na+).

Not for intravenous injection in dogs, cats or other small animals.

The addition of sodium bicarbonate to parenteral solutions containing calcium should be avoided, except where compatibility has been previously established. Precipitation or haze may result from sodium bicarbonate - calcium mixtures.

Dosage and Administration

Sodium Bicarbonate 7.5% Solution, administered by the intravenous route.

In general, caution should be observed in emergencies where very rapid injection of large quantities of bicarbonate is indicated - for example, in cardiac arrest. Sodium bicarbonate solutions are hypertonic and may produce an undesirable rise in plasma sodium concentration in the process of correction of metabolic acidosis. In cardiac arrest, however, the risks from acidosis exceed those of hypernatremia. The contents of one or more 100 cc vials of 7.5% solution may be given rapidly by the intravenous route, using a needle and syringe.

Sodium Bicarbonate 7.5% Solution (89.2 mEq. in 100 ml.) may be added to other intravenous fluids in less urgent forms of metabolic acidosis. The amount of bicarbonate to be given over a four-to-eight-hour period is approximately 2 to 5 mEq. per kg. of body weight, depending upon the severity of the acidosis as judged by the lowering of total CO₂ content, blood pH and clinical condition of the animal. Bicarbonate therapy should always be planned in a stepwise fashion since the degree of response from a given dose is not precisely predictable. Initially an infusion of 2 to 5 mEq. per kg. body weight over a period of 4 to 8 hours will produce a measurable improvement in the abnormal acid-base status of the blood. The next step of therapy is dependent upon the clinical response of the animal. If severe symptoms have abated, then the frequency of administration and the size of the dose may be reduced.

OVERDOSAGE: Should alkalosis result, the bicarbonate should be stopped and the animal managed according to the degree of alkalosis present. Sodium chloride injection (0.9%) intravenously may be given; potassium chloride also may be indicated if there is hypokalemia. Severe alkalosis may be accompanied by hyperirritability or tetany, and these symptoms may be controlled by calcium gluconate. An acidifying agent such as ammonium chloride may also be indicated in severe alkalosis.

How Supplied

Sodium Bicarbonate 7.5% Solution, Sodium Bicarbonate Injection (89.2 mEq.) is supplied in 100 mL vials.

Professional Veterinary Laboratories, REGINA - WINNIPEG - EDMONTON

CPN: 12030360