3 pH, pK, Henderson-Hasselbalch, Anion Gap, SID

7mg/kg w/ Epi 5mg/kg w/out Total 500mg

7mg/kg w/ Epi 5mg/kg w/out Total 500mg

3mg/kg w/ Epi 2mg/kg w/out Total 225mg

3.5mg/kg w/ Epi 3mg/kg w/out Total 300mg

1:1,000 (g/ml) = 1mg/ml = 1,000mcg/ml STOCK 1:10,000 = 0.1mg/ml = 100mcg/ml 1:100,000 = 0.01mg/ml = 10mcg/ml 1:200,000 = 0.005mg/ml = 5mcg/ml 1:400,000 = 0.0025mg/ml = 2.5mcg/ml 1:500,000 = 0.002mg/ml = 2mcg/ml g/ml x 10^6 = mcg/ml

pH = pK + log(UNprotonated/Protonated) pK = pH + log(Protonated/UNprotonated)

Ionized +/- BH+ A¯ (acid) H+ donator

Non-ionized (neutral) B (base) HA H+ acceptor

Log(a/b) = Log(a) - Log(b) Log(a/b) = - Log(b/a) - Log(a/b) = Log(b/a) Log(a·b) = Log(a) + Log(b) Log(1) = 0 1x10^0 Log(100) =2 1x10^2 Log(0.1 or 1/10) = -1 1x10-1 Log(0.01 or 1/100) = -2 1x10-2

H+ = 40nmole/L = 4 x 10^-5mEq/L K+ = 4,000,000nmole/L = 4mEq/L Ca2+ = 2,500,000nmole/L = 5mEq/L Mg2+ = 1,000,000nmole/L = 2mEq/L Na+ = 140,000,000nmole/L = 140mEq/L nmole/L (1x10^6) / 1,000,000 x charge +/-

pK = pH + log(Protonated/UNprotonated) BH+/B or A¯/AH

↑ non-ionized (unprotonated) = quicker onset time

nmol / 1,000,000 x charge +/- = mEq

BH+ ↔ B + H+ Conjugate acid ↔ Base + Proton Non-polar/neutral/base/UNprotonated form to cross lipophilic membrane Acidic environment ↑ H+ local anesthetic associates to protonated BH+ active form to act on VGNa+ channels from w/in the cell (intracellular action) pH or H+ concentration impacts direction (association or dissociation)

CO2 + H2O ↔ H2CO3 ↔ H+ + HCO3¯ Carbonic anhydrase enzyme facilitates reaction

pH = 6.1 + log(HCO3¯/H2CO3) pH = 6.1 + log(HCO3¯/(PaCO2 x 0.03))