Acid-base imbalances

Figure 2, Flow-chart for differential diagnoses of acid-base imbalance (1)...

Pathophysiology Muscle cramps can occur with up to 20% of dialysis sessions.48 The cause is often related to excessive ultrafiltration, which causes hypoperfusion of the muscles. Other contributing factors to the development of muscle cramps include hypotension and electrolyte and acid-base imbalances that occur during hemodialysis sessions. 

Schlichtig R, Grogono A, Severinghaus J. Human PaC02 and standard base excess for compensation of acid-base imbalances. Crit Care Med 1998 26 1173-1179. 

Acid-base imbalance Acute liver failure Amphetamines Anaphylaxis Autoimmune diseases Cholestasis Chronic inflammatory diseases... 

In early cardiac arrest, adequate alveolar ventilation is the primary means of limiting carbon dioxide accumulation and controlling the acid-base imbalance. With arrests of long duration, buffer therapy is often necessary. 

The answers are 264-c, 263-c. (Katzung, pp 519, 535-537.) Heroin and other opioids (such as morphine and meperidine) exhibit a high degree of tolerance and physical dependence. The tolerance rate magnitudes to all of the effects of opioids are not necessarily the same. The physical dependence is quite clear from the character and severity of withdrawal symptoms, which include vomiting spasms, abdominal cramps, diarrhea, and acid-base imbalances among others. 

Bushinsky D. 2001. Acid-base imbalance and the skeleton. Eur J Nutr 40 238-244. 

Disturbances in the GI system, such as nausea and cramps, may occur with laxative use. With prolonged use, serious lower GI irritation, including spastic colitis, may occur. Fluid and electrolyte abnormalities are also a potential problem. Excessive loss of water and the concomitant loss of electrolytes may transpire, resulting in dehydration and possible acid-base imbalances.44 These abnormalities are especially significant in older or debilitated patients. Finally, chronic administration may result in a laxative dependence when bowel evacuation has become so subservient to laxative use that the normal mechanisms governing evacuation and defecation are impaired. 

In early cardiac arrest, adequate alveolar ventilation is the primary means of limiting carbon dioxide accumulation and controlling the acid base imbalance. With arrests of long duration, buffer therapy is often necessary. Sodium bicarbonate administration for cardiac arrest is controversial because there are few clinical data supporting its use, and it may have some detrimental effects. Sodium bicarbonate can be used in special circumstances (i.e., underlying metabolic acidosis, hyperkalemia, salicylate overdose, or tricychc antidepressant overdose). The dosage should be guided by laboratory analysis if possible. 

Acute renal failure, e.g. cuninoglycosides, cisplatin Nephrotic syndrome, e.g. penicillamine, gold, cap-topril (only at higher doses than now recommended) Chronic renal failure, e.g. NSAIDs Functional impairment, i.e. reduced ability to dilute and concentrate urine (lithium), potassium loss in urine (loop diuretics), acid-base imbalance (acetazolamide). 

Treatment of chronic alcohol toxicity involves replacement of nutritional deficiencies such as thiamine, pyridoxine, and vitamins K and C. Correction of dehydration, electrolyte imbalance, and acid-base imbalances is of paramount importance. Chronic abuse may be associated with dependence liability. 

Research in a number of medical publications, such as the European Journal of Nutrition, links bone disorders such as fractures to acid—base imbalances.8 In his book Beautiful Bones Without Hormones, Dr. Leon Root states, Even a small drop in the body s pH can cause a dramatic increase in bone loss. 9 Remember that a drop in pH means an increase in acidity. 

Bushinsky, David A. Acid-Base Imbalance and the Skeleton. European Journal of Nutrition 40, no. 5 (October 2001) 238—44. 

Alterations of HCOj and CO2 dissolved in plasma are characteristic of acid-base imbalance. Its value has most significance in the context of other electrolyte values and with blood gases and pH values. The full clinical significance of the determination of total CO2 wiU become apparent in the following discussion of acid-base physiology. 

It is important to reverse the acid-base imbalance of lactate acidosis by the i.v. infusion of bicarbonate. 

Acidosis seen during cardiac arrest results from decreased blood flow and inadequate ventilation. Chest compressions generate approximately 20% to 30% of normal cardiac output, leading to inadequate organ perfusion, tissue hypoxia, and metabohc acidosis. In addition, the lack of ventilation causes retention of carbon dioxide, leading to respiratory acidosis. This combined acidosis produces not only reduced myocardial contractility and negative inotropic effect but also the appearance of arrhythmias because of a lower fibrillation threshold. In early cardiac arrest, adequate alveolar ventilation is the mainstay of control to limit the accumulation of carbon dioxide and control the acid-base imbalance. With arrests of long duration, buffer therapy often is necessary. 

Cramps 5-20 Muscle hypoperfusion due to ultrafiltration and hypovolemia Hypotension Electrolyte imbalance Acid-base imbalance... 

The concept of eqnilibrinm constants is extremely important in chemistry. As you will soon see, equilibrinm constants are the key to solving a wide variety of stoichiometry problems involving eqnilibrium systems. For example, an industrial chemist who wants to maximize the yield of sulfuric acid, say, must have a clear understanding of the equilibrium constants for all the steps in the process, starting from the oxidation of sulfur and ending with the formation of the final product. A physician specializing in clinical cases of acid-base imbalance needs to know the equilibrium constants of weak acids and bases. And a knowledge of equilibrium constants of pertinent gas-phase reactions will help an atmospheric chemist better understand the process of ozone destraction in the stratosphere. 

Therefore, one may safely draw an inference that these sulphonamide structural analogues competitively prevent the carbonic acid from getting bound at this specific site. Consequently, such an action shall obviously inhibit the prvailing action of the enzyme CA, thereby giving rise to an apparent acid-base imbalance that would ultimately cause diuresis. 

Barzel, U.S. (1995) The Skeleton as an Ion Exchange System Imphcations for the Role of Acid-Base Imbalance in the Genesis of Osteoporosis, J. Bone Miner. Res. 10,1431-1436. 

Two adjectives describe the general cause or origin of pH imbalances in body fluids metabolic and respiratory. Respiratory acid-base imbalances (respiratory acidosis and respiratory alkalosis) result from abnormal breathing patterns. Metabolic acidosis and metabohc alkalosis are caused by factors other than abnormal breathing. 

Some Causes of Blood Acid-Base Imbalance... 

Hyperventilation is a symptom of what type of acid-base imbalance in the body ... 

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