The functions and uses of sodium bicarbonate_industrial additives

Background and overview of the functions and uses of sodium bicarbonate

Sodium bicarbonate is a white crystal powder. Odorless, salty taste, strong water solubility. Easy to hydrolyze, the solution is weakly alkaline, unstable under heating conditions, easy to decompose, and will decompose slowly in humid air. Its preparation is usually suitable for alkalizing urine. Bicarbonate ions increase the pH value of urine. Substances such as uric acid, sulfonamide drug metabolites and hemoglobin are not easy to precipitate and crystallize in urine to avoid causing nephrotoxicity; sodium bicarbonate It is also used to treat sodium carbonate metabolic acidosis, increasing the concentration of carbonate ions in plasma and neutralizing hydrogen ions, thereby correcting acidosis. Oral sodium bicarbonate can also quickly neutralize gastric acid without affecting the normal secretion of gastric acid, rapidly increasing the pH value in the stomach and relieving adverse symptoms caused by hyperacidity. After years of research, the clinical application of sodium bicarbonate has expanded to many aspects, such as the nursing effect on the respiratory system and the prevention of adverse reactions in the digestive system. The use of sodium bicarbonate can reduce adverse reactions caused by drugs during treatment, help improve the condition, and shorten the course of treatment.

Function and purpose

After oral administration, it neutralizes gastric acid quickly and briefly, and can release a large amount of carbon dioxide. As an antacid, it is not suitable to be used alone, but is often used in combination with magnesium oxide, calcium carbonate and certain traditional Chinese medicines. It is easily absorbed when taken orally and has the effect of correcting acidemia and alkalinizing urine. Clinically used for patients with hyperacidity and gastric and duodenal ulcers; oral alkalinization of urine can prevent the effects of certain sulfa drugs on urinary tract infections; metabolic acidemia, hyperkalemia, and septic shock , early cerebral embolism, and those with severe status asthmaticus who are ineffective in other drug treatments, the dosage shall be determined according to the condition; for fungal vaginitis, local application will make the vagina alkaline to inhibit mold reproduction; ear drops are used to soften the cerumen.

Usage and dosage

Metabolic acidosis: Mild to moderate cases can be taken orally as tablets, 1 to 2 g each time, 3 to 4 times a day. Nowadays, the compound solution of this product with sodium chloride and potassium chloride is often taken orally. For severe cases, intravenous infusion is required, and the dose can be calculated according to the following formula: 5% sodium bicarbonate in milliliters = [50 – measured carbon dioxide binding capacity (V%)] × 0.5 × body weight (kg). Depending on the dehydration situation, 1.25% isotonic solution or 4% and 5% hypertonic solution can be used. 2. Vertigo: Add 20-60ml of 5% solution of this product into 20-40ml of 5% glucose saline, intravenously, once a day, and 6 days is a course of treatment. The second course of treatment is performed every other day. For severe cases, 300ml of 4% solution of this product can be administered intravenously, once a day. 3. Fungal vaginitis: 4% solution of this product is used to rinse the vagina or take a sitz bath, once a night, 500-1000ml each time, for 7 days. 4.3% solution of this product is used for ear drops to soften cerumen, 3 to 4 times a day.

Preparation specifications

Tablet: 0.5g. Injection: 0.5g/10ml, 5g/100ml.

Apply

1. Application progress in the treatment of metabolic acidosis

1) There are research reports on the therapeutic effect of exercise-induced rhabdomyolysis. Exercise-induced rhabdomyolysis is skeletal muscle damage caused by excessive exercise. Ischemia and hypoxia of the body’s striated muscle cells can cause discomfort to the body. It brings a series of serious consequences, such as electrolyte imbalance and even the production of myoglobin, causing casts to block the renal tubules and cause intrarenal obstruction. Because the condition of exercise-induced rhabdomyolysis is critical and there are no effective treatment measures after it occurs, clinical practice attaches great importance to the prevention of exercise-induced rhabdomyolysis. There are reports in the literature that divided warriors who competed in a 5000m cross-country race into groups and were given several different oral rehydration solutions. Muscle soreness and serum creatine kinase levels were then monitored to evaluate the effectiveness of different oral solutions in preventing exercise-induced rhabdomyolysis. The experimental results show that after oral administration of sodium bicarbonate solution, the ischemic symptoms of soldiers who exercised for a long time were improved, the glomerular filtration rate increased, and the risk of intrarenal diseases was reduced. At the same time, sodium bicarbonate can increase the pH of urine to prevent urine acidification, reduce the production of ferrous heme and the blocking effect of myoglobin on renal tubules, and accelerate the excretion of myoglobin and other substances. Oral bicarbonate is taken during exercise. Sodium solutions have an excellent preventive effect on the development of exercise-induced rhabdomyolysis.

2) Corrective acidosis treatment for malnutrition in chronic hemodialysis (HD) patients

HD patients are susceptible to external infections, hormone level disorders, nutritional and energy metabolism disorders and other conditions, resulting in loss of appetite, leading to malnutrition in HD patients. However, the malnutrition of some patients due to acidosis, an important factor, has not received enough attention. In a clinical observational study, 33 patients who received HD and were accompanied by malnutrition were corrected for acidosis by oral or intravenous infusion of sodium bicarbonate under adequate dialysis. The results showed that serum albumin, transferrin and other factors reflecting nutritional status were The indicators were significantly improved after treatment, and the patient’s independent protein synthesis ability was also improved. In addition, oral and intravenous infusion of sodium bicarbonate have basically the same efficacy. Both can improve the malnutrition of HD patients, accelerate the physical recovery of dialysis patients, and improve their quality of life.

2. Clinical expansion treatment situation

1) Therapeutic effect on respiratory system

Oral care for hand, foot and mouth disease: Role In recent years, hand, foot and mouth disease hasIf it occurs, it will bring great inconvenience to caregivers and patients. The main substances of enteral nutrition solution include minerals, vitamins and trace elements necessary for the human body, as well as artificial dextrin, casein, lecithin, vegetable fat, etc., which are easy to form clots, while 5% sodium bicarbonate solution is alkaline. The effectiveness of treating flecainide poisoning requires maximal supportive care to protect the cardiovascular and neurological systems until the effects of the drug have dissipated.

4) Therapeutic effect on the immune system: The main cause of gouty arthritis is purine metabolism disorder and reduced uric acid excretion caused by congenital or acquired factors. Gouty arthritis is a clinical syndrome of one or more lesions. In terms of treatment, surgical intervention is particularly important for patients with gouty arthritis. Try to use 5% sodium bicarbonate solution for intraoperative flushing to treat gouty knee arthritis, because the sodium bicarbonate solution itself can be intravenously infused to treat the disease, and even if it is absorbed in a small amount, it will not cause danger. Sodium bicarbonate has long been used in the treatment of early incision infections in orthopedics. Studies have shown that sodium bicarbonate can be used to flush infected incision tissue in humans for up to 1.5 months, and there are no cases of damage. Treatment of gouty knee arthritis with 5% sodium bicarbonate solution under arthroscopy can effectively and safely remove uric acid crystals in the joint cavity, minimize the residual metabolic waste in the body, and play a role in the damage to intra-articular cartilage, ligaments and other tissues. It has a protective effect, alleviates joint symptoms, reduces the possibility of recurrence, helps relieve joint pain and improve joint function.

5) Therapeutic effect in first aid: Paraquat, a herbicide widely used in my country, has a fatality rate of over 95% for oral poisoning. At this stage, the most effective way to treat paraquat oral poisoning in clinical treatment is early gastric lavage, and the decisive factor affecting the success rate of patient rescue is the type of gastric lavage solution used. The metabolism of paraquat in the body is relatively slow, and its toxic effects can persist and damage multiple organs. Most of the poisons accumulate in the lungs, seriously affecting the gas exchange function of the lungs, causing hypoxia in human tissues and organs, and even aggravating the internal organs. Functional failure and prognosis are extremely risky. According to the characteristics of paraquat being relatively stable in neutral solutions and acidic solutions and easily decomposing in alkaline environments, the early use of alkaline sodium bicarbonate gastric lavage solution and intravenous infusion of sodium bicarbonate can help remove toxic substances from the body. Save the lives of patients with paraquat poisoning and effectively improve the effectiveness of clinical treatment.

6) Therapeutic effect in the field of cancer: An improved therapy of transcatheter arterial chemoembolization (TACE) was reported for the treatment of hepatocellular carcinoma with large tumors but not spread. This therapy involves injecting 5% sodium bicarbonate solution into the tumor while performing arterial catheter chemotherapy. The literature mentioned two clinical trials. One of the randomized trials pointed out that the objective response rate of patients treated with TACE combined with sodium bicarbonate was higher than that of patients without combination. The former reached 100%, while the latter was only 63.6%. After improving the method by combining the injection of NaHCO3 solution with intubation chemotherapy, a therapy called “TACE targeting the accumulation of lactic acid in the tumor” was launched. This method achieved a high objective response rate. This result is consistent with the results of previous in vitro studies because they all believe that the tumor microenvironment created after injecting alkaline sodium bicarbonate has the effect of preventing the increase of lactic acid in the tumor. . Cancer cells improve their tolerance to glucose starvation by increasing the amount of metabolic lactic acid, while the injection of sodium bicarbonate reduces the amount of lactic acid and weakens the tolerance of cancer cells to glucose starvation. Increased acidity and accumulation of lactate are two manifestations of increased lactic acidity. Cancer cells with insufficient glucose in the body rely more on increasing the amount of acid to survive, rather than increasing the concentration of lactate as is generally believed. Without affecting the lactate concentration, sodium bicarbonate solution is directly injected into the tumor to change the pH of the tumor’s living environment, allowing tumor cells to survive in an unfavorable environment and cause them to undergo apoptosis. The injection of sodium bicarbonate uses its alkaline physical properties to change the microenvironment of liver tumor cells, accelerate the apoptosis of liver tumor cells, promote the objective remission rate of liver cancer patients, and effectively control the disease.