What is a possible adverse reaction of sodium bicarbonate?

Sodium bicarbonate is an alkaline substance that acts as an antacid and is commonly used to neutralize stomach acid and correct metabolic acidosis. When sodium bicarbonate is administered, particularly in excessive amounts or in the context of certain underlying health conditions, it can lead to an increase in blood pH. This elevated pH is what is classified as metabolic alkalosis.

Metabolic alkalosis occurs when there is an excess of bicarbonate in the blood, resulting in symptoms such as muscle twitching, hand tremors, and in severe cases, respiratory depression. This reaction can be especially pronounced in patients with impaired kidney function or those receiving large doses of sodium bicarbonate over time. In clinical practice, careful monitoring of blood electrolytes and acid-base status is crucial when administering sodium bicarbonate to prevent this complication.

The other choices, while they may occur in different contexts or drug interactions, are not the primary adverse reaction associated with sodium bicarbonate. Hypokalemia, nausea, and diarrhea can arise from various conditions or medications, but metabolic alkalosis stands out as a direct and significant risk related to the use of sodium bicarbonate, emphasizing the importance of managing bicarbonate levels effectively during treatment.