Urinary pH (alkalinization ↑ clearance)
- Alkaline urine increases excretion of weak acids
- Ionized drug is trapped in tubular fluid
- Salicylate toxicity is the classic use
- Requires adequate kidney function/urine flow
- Monitor K+ and systemic pH during bicarbonate therapy
Interaction at a glance
- Alkaline urine increases excretion of weak acids
Mechanism
- Alkaline urine increases excretion of weak acids
- Ionized drug is trapped in tubular fluid
- Requires adequate kidney function/urine flow
Clinical consequence
- Salicylate toxicity is the classic use
Monitoring
- Monitor K+ and systemic pH during bicarbonate therapy
Self-check
- What poisoning classically benefits from urinary alkalinization?
Salicylate toxicity.
- What should be monitored during bicarbonate alkalinization?
Potassium and systemic pH.
Drugs in this interaction (5)
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