ACID BASE BALANCE – ALKALOSIS
Definition:
- Metabolic alkalosis is a condition of the body where the blood becomes too alkaline due to excess bicarbonate in the blood.
Types:
- Primary metabolic alkalosis
- Secondary metabolic alkalosis
Causes:
- Excessive vomiting
- Diuretic use
- Certain medications (e.g. steroids, theophylline)
- Congenital adrenal hyperplasia
- Mineralocorticoid excess
- Prolonged nasogastric suction
- Prolonged parenteral nutrition
- Certain metabolic disorders (e.g. cystinuria, oxalosis)
Clinical Features:
- Nausea and vomiting
- Abdominal pain
- Fatigue
- Muscle weakness
- Tinnitus
- Headache
- Confusion
- Seizures
Laboratory Findings:
- Serum pH > 7.45
- Serum bicarbonate > 28 mmol/L
- Anion gap < 10 mmol/L
- Potassium < 3.0 mmol/L
- Calcium > 2.5 mmol/L
- Phosphate < 1.0 mmol/L
Complications:
- Hypokalemia
- Hypocalcemia
- Hypophosphatemia
- Cardiac arrhythmias
- Respiratory alkalosis
Management:
- Identify and treat the underlying cause
- Administer potassium supplements
- Administer calcium supplements
- Administer phosphate supplements
- Administer bicarbonate-rich fluids (e.g. normal saline)
- Monitor serum electrolytes
Homoeopathic Therapeutic Approach:
- Natrum muriaticum for hyperchlorhydria
- Carbo vegetalis for excessive vomiting
- Ferrum phosphoricum for hypokalemia
- Calcarea phosphorica for hypocalcemia
- Kali phosphoricum for hypophosphatemia
Treatment:
- Primary metabolic alkalosis: correct underlying cause, administer potassium supplements, and monitor serum electrolytes
- Secondary metabolic alkalosis: treat underlying cause, administer potassium supplements, and monitor serum electrolytes