Diacartic Acid (Sodium Bicarbonate)

Adult administration

1. When using the specified acetate-containing dialysis solution (Solution A), this preparation makes about 180L of bicarbonate-type blood dialysis solution containing 38mEq/L of HCO_3. 2. The dilution ratio for Solution A of acetate-containing dialysis solution is 1: (this medication + purified water) 34, used for hemodialysis with a bicarbonate-type dialysis solution dispenser. 3. When preparing dialysis solution for one patient (based on 6 hours), the mixing ratio is as follows.

This medication should not be used in patients with low blood pressure and very rapid heart rate. It should also not be administered to patients with pulmonary edema or abnormal cardiac electrical activity, patients with high serum potassium levels, and patients with coagulation problems. Caution should be exercised in patients with severe liver disease or severe diabetes that may affect metabolism, as this may suppress heart function or cause vascular dilation and low blood pressure. Patients taking digitalis preparations should use this medication carefully to avoid the risk of drug toxicity due to low serum potassium levels. Attention should be given to the use of this medication when serum calcium and phosphorus levels are high before hemodialysis, as this may lead to abnormal calcification. There is a risk of hypoglycemia in patients with insufficient caloric intake or those with diabetes who have dietary restrictions or are taking blood sugar-lowering agents, so caution is warranted. Hypoglycemic symptoms may occur during the use of this medication; if blood sugar drops, appropriate measures such as glucose injection or sugar supplementation should be taken. Since serum calcium levels may increase, it is necessary to switch to a dialysis solution with low calcium levels if hypercalcemia is confirmed. Bone-related complications such as osteoporosis, osteomalacia, and fibrous osteitis may occur, and appropriate treatment such as the administration of active vitamin D_3 preparations may be necessary in such cases. If abnormal calcification occurs, measures to maintain serum phosphorus levels within the normal range, such as the administration of phosphorus binders, are required. During dialysis, symptoms such as headache, nausea, vomiting, seizures, and altered consciousness may occur, and in such cases, it is necessary to take measures such as reducing the dialysis speed. There may be a rapid decrease in blood circulation causing hypotension or symptoms of shock; if these symptoms occur, dialysis should be stopped or the speed reduced, and necessary medications should be administered. This medication is used for hemodialysis in patients with chronic renal failure, especially when it is difficult to improve metabolic acidosis or when symptoms such as low blood pressure or imbalance syndrome occur during the dialysis process. For patients who have difficulty controlling hyperglycemia due to glucose metabolism abnormalities, using this medication without glucose may be helpful. During treatment, it is important to regularly check electrolytes, acid-base balance, blood sugar, and other conditions through blood tests. Pregnant women or those who may become pregnant should only use this medication if the benefits outweigh the risks, as its safety has not been established. The safety for children has not been sufficiently confirmed, so it should be used cautiously in children. Elderly patients should use this medication with careful consideration of its characteristics, and since there is a possibility of bone complications with long-term use, regular examinations and administration of active vitamin D_3 preparations when necessary are needed. For dilution of the dialysis solution, thoroughly purified water should be used, and attention should be paid to damage to the dialysis membrane and tendency for bleeding. When preparing, do not mix the electrolyte solution for artificial kidney dialysis with the sodium bicarbonate solution, and adhere to the specified dilution concentrations. If the dilution concentration is too high or too low, symptoms such as headache, palpitations, blood pressure abnormalities, and altered consciousness may occur, so caution must be exercised. 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. This medication should not be used for injection or peritoneal lavage, and the dialysis solution should be maintained at body temperature during use.

Serious side effects

• Seizures
• altered consciousness
• disturbance of consciousness

Mild side effects

Hypoglycemia, hypercalcemia, osteoporosis, osteomalacia, fibrous osteitis, ectopic calcification, symptoms of dialysis imbalance syndrome (headache, nausea, vomiting, discomfort, fatigue), hypotension, blood pressure increase, palpitations, numbness in limbs, general fatigue, chest discomfort, altered consciousness

This medication should be stored in a tightly sealed container to protect it from air or moisture. Also, it is important to store it at room temperature below 40 degrees Celsius to maintain its efficacy.

Appearance

White crystalline or crystalline powder contained in a polypropylene bottle

Package unit

650g (Plastic bottle)