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Excessive use of bicarbonate or bicarbonate-forming compounds may lead to hypokalaemia and metabolic alkalosis, especially in patients with impaired renal function. Symptoms include mood changes, tiredness, slow breathing, muscle weakness, and irregular heart-beat. Muscle hypertonicity, twitching, and tetany may develop, especially in hypocalcaemic patients.
Treatment of metabolic alkalosis associated with bicarbonate overdose consists mainly of appropriate correction of fluid and electrolyte balance. Replacement of calcium, chloride, and potassium ions may be of particular importance.
