Acidosis and Alkalosis

  • Acidosis and Alkalosis can have serious and fatal consequences

  • Acidic and Basic agents may be given to rapidly correct pH imbalance

  • homeostasis – pH maintained @ 7.35-7.45

  • the body generates acids during normal metabolism

  • Biochemical Buffers: Bicarbonate ions and phosphate ions

Acidosis: abnormally high acidity (excess hydrogen-ion concentration) of the blood and other body tissues

Mechanisms of acid removal:


  • Exhalation of CO2: waste produced during metabolism is removed via exhalation @ the lungs

  • H+ ions excreted via the kidneys: in urine


Pharmacotherapy of Acidosis


  • occurs when physiological pH fall below 7.35

Acidosis Symptoms:

  1. lethargy

  2. confusion

  3. CNS depression leading to coma

  4. dizziness

  5. headache

  6. seizures

  7. hyperventilation – deep rapid respiration rate indicates an attempt by the lungs to rid the body of excess acid.

Acidosis causative factors


  • diabetes mellitus

  • shock

  • diarrhea

  • vomiting

Causes of Alkalosis and Acidosis




Respiratory Origins

  • Hypoventilation or shallow breathing

  • airway constriction

  • damage to respiratory center in medulla

  • Hypoventilation due to asthma, anxiety or high altitude

Metabolic Origins

  • Severe diarrhea

  • kidney failure

  • diabetes mellitus

  • excess alcohol ingestion

  • starvation

  • Constipation for prolonged periods

  • ingestion of excess sodium bicarbonate

  • diuretics that cause potassium depletion

  • severe vomiting

Alkalosis: abnormally high alkalinity (low hydrogen-ion concentration) of the blood and other body tissues



  • Patients taking sodium bicarbonate, contained in household baking soda are at risk for alkalosis


Alkalosis Symptoms


  • irritability

  • confusion

  • cyanosis

  • decreased respiration rate

  • irregular pulse

  • muscle twitching – hyperactive reflexes

  • convulsions

Pharmcotherapy of Alkalosis


  • plasma pH above 7.45

  • slow shallow breathing indicates the body is attempting to retain acid and lower internal pH

  • mild cases can be corrected by administration of KCl

  • this increases renal excretion of bicarbonate ions, increasing the acidity of the blood

  • More severe cases may be treated with infusions of NH3Cl

 Adams, Micheal, Patrick, Bostwick, Paula, Manuel, Holland, Leland, Norman jr, and King, Shirley, Linda. 2009. Pharmacology for Nurses: A pathological approach. Pearson Canada, Toronto.


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