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What are the effects of sodium bicarbonate injection?

Nov 25, 2025 Source: Cainiu Health
Dr. Wang Lei
Introduction
Sodium bicarbonate injection is mainly used to correct metabolic acidosis, alkalinize urine, neutralize gastric acid, serve as a solvent for certain drugs, and treat some types of poisoning. The dosage should be adjusted according to the patient's condition and blood gas analysis results to avoid overdose that may lead to metabolic alkalosis. Electrolyte levels and acid-base balance parameters should be monitored during treatment to ensure safe medication use.

Sodium bicarbonate injection has several main functions, including correcting metabolic acidosis, alkalinizing urine, neutralizing gastric acid, serving as a drug solvent, and treating certain types of poisoning. The details are as follows:

1. Correcting metabolic acidosis: This medication directly replenishes bicarbonate ions in the body, increases blood pH, and relieves symptoms of acidosis. It is suitable for metabolic acidosis caused by conditions such as diabetic ketoacidosis, renal insufficiency, and severe diarrhea, and is particularly effective in severe cases with a pH below 7.2.

2. Alkalinizing urine: By increasing urinary pH, it alters the acidity of urine. This promotes the dissolution of acidic substances such as uric acid and sulfonamides in urine, preventing them from forming crystals that could obstruct renal tubules. It also enhances the antibacterial activity of aminoglycoside antibiotics like gentamicin in the urinary tract.

3. Neutralizing gastric acid: Administered via intravenous infusion or oral route, it can neutralize excess gastric acid, alleviating symptoms such as stomach pain, acid reflux, and heartburn caused by excessive gastric acid. It is commonly used clinically during acute episodes of peptic ulcers to rapidly reduce irritation to the gastric mucosa.

4. Serving as a drug solvent: Some medications easily degrade and become ineffective in acidic environments. Sodium bicarbonate can be used as a solvent for preparing such drugs, including penicillin and cephalosporin antibiotics. It helps maintain the stability of the drug solution, ensuring therapeutic efficacy and preventing toxic side effects due to drug degradation.

5. Treating certain poisonings: In cases of poisoning by acidic drugs such as barbiturates and salicylates, this agent promotes excretion of toxins by alkalinizing the blood and urine. It also reduces damage caused by acidic toxins to the central nervous system and organs, buying time for further emergency treatment.

Dosage of this drug should be adjusted based on the patient's condition and blood gas analysis results to avoid excessive administration leading to metabolic alkalosis. Electrolyte levels and acid-base balance should be monitored during treatment to ensure safety, especially when used cautiously in patients with impaired cardiac or renal function.

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