General Description
Sodium phosphate, dibasic (disodium hydrogen phosphate) is an inorganic salt used as a source of phosphate and sodium for parenteral nutrition and electrolyte replacement. It is available as a crystalline powder and in sterile solutions for intravenous or oral administration. This agent plays a critical role in maintaining acid-base balance and providing substrate for cellular energy metabolism.
Mechanism of Action
Upon administration, dibasic sodium phosphate dissociates into sodium and monohydrogen phosphate ions, contributing to plasma phosphate and sodium pools. Phosphate is essential for adenosine triphosphate synthesis, 2,3-diphosphoglycerate production in erythrocytes, and as a component of cell membranes and nucleic acids. The monohydrogen form also acts as a buffer, accepting hydrogen ions to maintain systemic pH in metabolic acidosis.
Application
It is indicated for the treatment and prevention of hypophosphatemia in patients with inadequate dietary intake, malabsorption, refeeding syndrome, or renal phosphate wasting. Intravenous administration is reserved for severe hypophosphatemia (serum phosphate less than 1.0 mg/dL) in critically ill patients. Oral formulations are also used as osmotic laxatives for bowel cleansing prior to colonoscopy, though this use requires careful monitoring due to risk of acute phosphate nephropathy.