Disorders and Drugs Associated with Altered Serum Bicarbonate Levels

Increased Serum Bicarbonate

Disorders

• Metabolic alkalosis
• Compensated metabolic alkalosis
• Respiratory acidosis (slightly elevated or normal)
• Compensated respiratory acidosis
• Hypoventilation
• Chronic obstructive pulmonary disease
• Vomiting
• Nasogastric suction
• Diuresis
• Aldosteronism
• Congestive heart failure
• Hypokalemia
• Cushing's syndrome
• Pulmonary edema
• Milk-alkali syndrome

Drugs

• Aldosterone
• Adrenocorticotropic hormone
• Sodium bicarbonate abuse
• Adrenocorticosteroids
• Viomycin
• Thiazide diuretics

Decreased Serum Bicarbonate

Disorders

• Metabolic acidosis
• Compensated metabolic acidosis
• Respiratory alkalosis (slightly low or normal)
• Compensated respiratory alkalosis
• Hyperventilation
• Diarrhea
• Dehydration
• Severe malnutrition
• Burns
• Myocardial infarction
• Acute ethanol intoxication
• Shock
• Renal disease
• Hyperthyroidism

Drugs

• Triamterene (Dyrenium)
• Acetazolamide (Diamox)
• Calcium chloride
• Ammonium chloride
• Salicylate toxicity
• Paraldehyde
• Sodium citrate