Thursday, December 20, 2012

Alkalinization of urine

I am sharing some of the applications since it is not put up together on the internet.. So here it goes!

How do you alkalinize urine?
The urine can be alkalinized (the pH elevated) by administering sodium bicarbonate or potassium citrate. Carbonic anhydrase inhibitiors like acetazolamide can also be used.

Cool fact:
Citrate containing fruits like lemons and limes alkalize urine.
Citric acid is not to be confused with ascorbic acid (vitamin C).
Ascorbic acid is used for acidification of urine.
Citric acid is used for alkalinization of urine.

Uses of alkalinization of urine:
• Forced alkaline diuresis has been used to increase the excretion of acidic drugs like salicylic acid and phenobarbitone (a weak acid barbiturate)
Simply because weak acids ionize at alkaline pH and will not be re-absorbed.

• To decrease risk of nephrotoxicity in methotrexate therapy.

• In dimercaprol therapy
The dimercaprol-metal complex dissociates faster in acidic urine.
The released metal can damage the kidney.
That is why, urine is alkalinized :)

• In rhabdomyolysis
Alkalinization of the urine has been postulated to minimize the breakdown of myoglobin into its nephrotoxic metabolites & to reduce crystallization of uric acid, thereby decreasing damage to tubule cells.

Uric acid, cystine, and some other weak acids are relatively insoluble in, and easily reabsorbed
from, acidic urine. Thus, it can be used to prevent crystallization of excess urate in urinary tract during probenecid treatment in chronic gout or hyperuricaemia occurring as a consequence of rapid destruction of tumor and degradation of large amounts of purines during anticancer therapy & cystinuria.

Also note that -
Calcium salts are relatively insoluble at alkaline pH, which means that the potential for renal stone formation from these salts is enhanced.
Alkalinization of the urine will decrease urinary excretion of NH4+ and may contribute to the development of hyperammonemia and hepatic encephalopathy in patients with cirrhosis.

Did you know?
Some antacids (eg, magnesium hydroxide with aluminum hydroxide) alkalize the urine somewhat, thus altering excretion of drugs sensitive to urinary pH.

That's all I have to say :)
It's amazing how pH influences drug ^__^
But there is more to it, we don't know everything about the mechanisms.
Click here to know why I say so --> http://www.ncbi.nlm.nih.gov/pubmed/15181662

Lemme know if you know of some other applications!

-IkaN
(It's 20/12/2012) :D

Related post: Acidification of urine

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