CMPB Powder (Sodium Bicarbonate)

Adult administration

1. When using the specified acetate dialysis solution (Solution A), this preparation can produce approximately 180L of bicarbonate-type hemodialysis solution containing 38mEq/L of HCO3-. 2. This drug is used as dialysis solution when utilizing the supply system for bicarbonate-type dialysis solution in a dilution ratio of 1:34 of acetate-based dialysis solution (Solution A) to (this drug + purified water). 3. For a single use of dialysis solution for a patient (based on 6 hours), the mixing ratio is as follows.

This drug should not be used in patients with low blood pressure and a very rapid heart rate. Patients with pulmonary edema or abnormalities in cardiac electrical activity should also not be administered this drug. Patients with high potassium levels in the blood and those with blood coagulation issues should avoid this medication. Patients with severe liver disease or metabolic issues due to diabetes should use this medication with caution. Patients taking digitalis should be cautious due to the risk of drug toxicity from lower serum potassium levels. Patients with very high calcium and phosphorus levels prior to hemodialysis should be careful, as this drug can cause calcium deposition. Patients with inadequate calorie intake or dietary restrictions due to diabetes or those using blood sugar-lowering agents should be cautious due to the risk of hypoglycemia. This medication can induce hypoglycemic symptoms, so if symptoms of low blood sugar occur during or after dialysis, appropriate measures such as glucose injection or sugar replenishment must be taken immediately. Serum calcium levels may increase, hence if hypercalcemia is suspected, it is advisable to switch to dialysis solution with low calcium concentration. Due to potential complications related to bones, such as osteoporosis, osteomalacia, and fibrous osteitis, appropriate treatment with active vitamin D3 preparations is necessary. High phosphorus levels in the blood may lead to ectopic calcification, so phosphorus binders should be used to maintain phosphorus levels within normal ranges. Symptoms of dialysis disequilibrium syndrome, such as headache, nausea, vomiting, cramps, and altered consciousness, may appear, necessitating actions like reducing dialysis speed in response to these symptoms. This drug can influence the circulatory system, potentially causing hypotension or shock; thus, if symptoms occur, treatment such as stopping dialysis or administering fluids and antihypertensive medications may be necessary. Rarely, blood pressure can increase, hence it should be managed through antihypertensive medication or modification of dialysis solution. This medication is used for hemodialysis in chronic renal failure patients, particularly when metabolic acidosis cannot be improved with high acetate dialysis solution, or in severe cases of dialysis disequilibrium syndrome and hypotension. Additionally, this medication can be used in cases where adequate fluid removal is difficult. It is suitable for patients with hyperglycemia who find glucose-containing dialysis solutions difficult to control. It is crucial to regularly check electrolytes, acid-base balance, and blood sugar through blood tests. The safety during pregnancy has not been established, so pregnant women or those with the potential for pregnancy should use it only when the benefits outweigh the risks. The safety for children has also not been established. Elderly patients should understand the characteristics of this medication well and use it cautiously, as there is a risk of bone-related complications with prolonged use, requiring regular monitoring and administration of active vitamin D3 preparations if needed. The dilution water for dialysis should use strictly purified water, and attention must be paid to any potential damage to dialysis membranes and risks of post-surgical bleeding. When preparing, do not mix the electrolyte solution for artificial kidney dialysis directly with sodium bicarbonate solution; it should be prepared accurately using the designated diluent. If the dilution concentration is too high or too low, side effects such as headaches, palpitations, abnormal blood pressure, and altered consciousness can occur, so caution is advised. It is preferable to check the electrolyte concentration and pH of the dialysis solution before use, and the diluted dialysis solution should be used immediately. It should not be used for injection or peritoneal dialysis, and dialysis solutions should be maintained at body temperature and not stored for more than 2 hours.

Mild side effects

• Hypoglycemia
• hypercalcemia
• osteoporosis
• osteomalacia
• fibrous osteitis
• ectopic calcification
• headache
• nausea
• vomiting
• cramps

This medication should be stored in a tightly sealed container to prevent exposure to air or moisture and kept at room temperature between 1 degree and 30 degrees Celsius. Storing it this way helps to maintain the efficacy of the medication.

Appearance

White crystalline powder contained in a white polyethylene bag

Package unit

16.8 kilograms per box [8.4 kilograms per pack * 2]