Sodium bicarbonate renal tubular reabsorption

Sodium bicarbonate increases renal tubular reabsorption of amphetamine, resulting in a prolonged amphetamine elimination half-life be aware of this combination. 

The answer is a. (Hardman, pp 16-20.) Sodium bicarbonate is excreted principally in the urine and alkalinizes it. Increasing urinary pH interferes with the passive renal tubular reabsorption of organic acids (such as aspirin and phenobarbital) by increasing the ionic form of the drug in the tubular filtrate. This would increase their excretion. Excretion of organic bases (such as amphetamine, cocaine, phencyclidine, and morphine) would be enhanced by acidifying the urine. 

Vaupshas H J, Levy M 1990 Distribution of saline following acute volume loading postural effects. Clinical and Investigative Medicine 13 165-177 Velanovich V 1989 Crystalloid versus colloid fluid resuscitation a meta-analysis of mortality. Surgery 105 65-71 Vukmir R B, Bircher N G, Radovsky A et al 1995 Sodium bicarbonate may improve outcome in dogs with brief or prolonged cardiac arrest. Critical Care Medicine 23 515-522 Walton R J 1979 Effect of intravenous sodium lactate on renal tubular reabsorption of phosphate in man. Clinical Science 57 125-127... 

These results suggest acute renal failure (ARF) due to tubular necrosis caused by phenol. Plasma sodium is low due mainly to impaired reabsorption in the nephron, although the slightly low albumin suggests haemodilution possibly as a result of excessive i.v. fluids. Potassium is raised due to poor exchange with sodium in the distal tubule and the acidosis (low pH and low bicarbonate concentration) arises from defective acidification of the glomerular filtrate acidosis is often associated with hyperkalaemia (raised plasma... 

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