Acid Base Regulation-General Aspects – howMed

Strong Acid: Greater tendency to dissociate into free H+ & Anions e.g. HCl
Weak Acid: Only less no of molecules dissociate in solution e.g.: H2CO3

Bases: Accept free H+ ions

Strong Base: is able to bind H+ ions more readily than weak base
K : Dissociation constant Every acid has constant degree of dissociation, when in solution

[H+] [(HCO-3]/ [H2 CO3] = K

ACID BASE REGULATION

Buffer: A substance that can reversibly bind H+

The ‘pair of substances’ are involved in reversible reaction:- – One substance can yield free H+ ions when [H+] decreases. – Other substance can bind free H+ ions when [H+] starts rising.

Buffer + H+ ↔ H.Buffer

Buffering: Process by which a strong acid (or base) is replaced by a weaker acid/ base with a consequent reduction in a number of ‘free H+ ions’ i.e. ‘Shock’ of H+ ions is taken up by buffer. Therefore, change in pH after addition of acid is less than it would be in absence of buffer. “Buffer solution resists a change in pH”

H+ Cl-            + Na+ HCO-3 → H2 CO3 +      Na+ Cl-

Strong Acid Buffer           weak Acid     Neutral salt.

pH

• It is a measure of H+ ion activity, expressed as –ve log [H+] or = log 1/[H+] • pH = log to the base 10 to the reciprocal of [H+] • Thus High [H+] = Low pH Low [H+] = High pH • Every unit change in pH actually represents a ten fold change in [H+], because of log relationship.

Normal [H+] in body = 40 x 10-9 Eq/l

or 40 ± 3 = nEq/l or 0.00004 mEq/l

Normal pH = 7.4

pH of Arterial Blood = 7.45 pH of Venous Blood = 7.35

Normal Range = 6.8 – 8.0 Beyond which death occurs in seconds.

Acidosis = Blood pH < 7.35
Alkalosis = Blood pH > 7.45

pH of ICF is lower than plasma i.e. 6.0 – 7.4
pH of urine ranges between 4.5 – 8.0
Extreme Acidic pH in body is of gastric Acid = 0.8

Addition of H+ into the Body Fluids

• Body’s metabolic processes always produce ‘Acids’
• Daily production of H+ ions by metabolism or ingestion with food [e.g. Citric Acid in oranges] = 80 mEq/L

• Types;

i. Respiratory or Volatile acids; CO2
ii. Metabolic or fixed acids

• To maintain balance ‘acids’ are to be; “Excreted” or “Metabolized”
Non-volatile acids (fixed acids), not excreted by lungs but excreted by kidneys

Fixed acids:

• Acids other than H2CO3 are ‘fixed acids’. • Commonly referred as their ‘anions’ e.g. lactate, phosphate, sulphate, acetoacetate or β-hydroxybutarate. [Amount of anions reflect the no. of H+]. • Net production of fixed acids = 1-1.5 mmoles /kg/day = 70-100 mmoles of H + /day in adults.

• Fixed acids: produced due to incomplete metabolism of carbohydrates (lactate), fats (ketones) & proteins (sulphate, phosphate)

• Lactate: not commonly included in ‘net fixed acids’ because it is metabolized & not excreted.

Three sources of Continuous Addition of H+ ions:

1. Carbonic Acid Formation : i.e. Hydration of CO2

– Cellular oxidation of nutrients yield = Energy + CO2 + H20 – CO2 is a volatile Acid (Respiratory Acid; H2CO3); 13,000 – 20,000 mM/day – CO2 itself is ‘neither an acid’ & ‘nor the proton donor’, instead has the

potential to create equivalent amount of H2CO3

2. Inorganic Acid formation:

During break down of proteins, phospholipids Meat proteins contain sulpher (Sulphuric Acid) & phosphorus (Phosphoric Acid) Fixed Acids = Inorganic + Organic Acids = 40 – 60 mM/day

‘Vegetables & Fruits yield bases to neutralize acids’.

3. Organic Acid:

Resulting from intermediary metabolism e.g.

Lactic Acid from Carbohydrates Fatty Acids from Fats

β-hydroxy butyric & Acetoacetic Acid

Effects of Fluctuations of H+

Only narrow range of pH (6.8 – 8.0) is compatible with life.
1. Changes in excitability of nerve & muscle cells: ↑ [H+] i.e. Acidosis → Depression of CNS Disorientation & Death. ↓ [H+] i.e. Alkalosis → Over excitability of CNS (convulsions) First in peripheral Nerves than in CNS

Sensory effects: Tingling (‘pins & needle’ sensation)

Motor effects : Muscle twitches/spasm
Extreme Alkalosis → Spasm of Resp. muscles & Death

2. Changes in Enzyme Activity:

By altering shape & activity of protein molecules.
Some reactions are accelerated, others are depressed.

3. Change in K+ levels in Body Fluids:

Normally in nephron; * Na+ reabsorption exchanges with secretion of H+ or K+ * K+ ions are secreted more than H+

In Acidosis: H+ ion are eliminated more than K+

i.e. Hyperkalemia → Cardiac dysfunction

Body’s Response to Change in Acid-Base Status

Precise regulation or maintenance of ‘free H+ ions’ in body fluids. Balance is Achieved by Three Defense Mechanisms:-

First defense: Chemical buffering

2nd defense: Respiratory (alteration in arterial CO2)
3rd defense: Renal (alteration in HCO-3 excretion)

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Regulation of Acid Base Balance