TABLE 1514 Agents That Other Modalities May Increase Their Excretion

Administer an intravenous bolus of 1 to 2 meq/kg sodium bicarbonate, followed by either intermittent boluses of sodium bicarbonate or a continuous intravenous infusion to achieve a urinary pH of 7.5 to 8.0. Serum pH should not be allowed to rise above 7.5 to 7.55. Pronounced hypokalemia may result from this technique and must be corrected aggressively. Hypokalemia induces the kidneys to reabsorb potassium preferentially. To remain electronegatively neutral, hydrogen ions are excreted, inhibiting the production of an alkaline urine. This may result in a paradoxically acidic urine.

The benefit of urinary alkalinization is a decrease in toxin serum half-life from increased urinary excretion. The risks include congestive heart failure, pulmonary edema, pH shifts, and profound hypokalemia. Therefore, contraindications to this procedure include patients who cannot tolerate the volume or sodium load, hypokalemia, renal insufficiency, and ingestion of a toxin that does not respond to alkalinization.

Dealing With Back Pain

Dealing With Back Pain

Deal With Your Pain, Lead A Wonderful Life An Live Like A 'Normal' Person. Before I really start telling you anything about me or finding out anything about you, I want you to know that I sympathize with you. Not only is it one of the most painful experiences to have backpain. Not only is it the number one excuse for employees not coming into work. But perhaps just as significantly, it is something that I suffered from for years.

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