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ACID BASE BALANCE
Dr. Ifat Ara Begum
Assistant Professor
Dept. of Biochemistry
Dhaka Medical College
Dhaka
CLASS PLAN
Basic facts: Repetition
Regulation of acid base balance
Pathophysiology of different
acid base disorders
DAY-1
Review on acid/base/pH/ buffers/
H-H Equation
Origin of acids and bases in our
body
Acidity of solution
pH & the effects of pH change
ACIDS
These are the molecules having
hydrogen atom and can donate
hydrogen ion ( H+
/ Proton) in
aqueous solution.
In simple words:
Acids are H+
/ Protondonor
HYDROGEN ATOM &
HYDROGEN ION (PROTON)
 Proton means hydrogen atom with its
electron removed
CONTD
CONJUGATE BASE OF AN
ACID
Conjugate base of an acid is the
anionic part of an acid after
removal of proton from the acid
C
Rapidly &
completely ionized
in solution (body
fluids) into H+ & its
conjugate base.
Degree of
dissociation &
dissociation
constant is high
pK value: Low
Slowly & partially
ionized in solution
(body fluids) into H+
& its conjugate base.
Degree of
dissociation &
dissociation
constant is low
pK value: High
Strong Acid Weak Acid
As conjugate base
shows less affinity to
H+, rapid and
complete ionization
to proton occurs. So,
conjugate bases of
strong acids are
weak.
Example: All
inorganic acids
except H2CO3
As conjugate base
shows strong affinity
to H+, slow and
partial ionization to
proton occurs. So,
conjugate bases of
weak acids are strong.
Example: All organic
acids and H2CO3
Strong Acid Weak Acid
BASES
These are the molecules that can
accept H+
(Proton) in aqueous
solution.
In simple words, bases are H+
/
Proton acceptor
After accepting proton, conjugate
acid of that base is formed.
Bases may be charged like Cl-
,
HCO3
-
or without charge like NH3
CONJUGATE ACID OF A
BASE
C
Have greater
tendency to accept
proton.
Bind rapidly &
strongly with proton,
so, remove them
quickly from solution
Conjugate acid: weak
Example: HCO3
-
Have low tendency
to accept proton.
Bind slowly &
weakly with proton,
so, remove them
slowly from solution
Conjugate acid:
strong
Example: Cl-
Strong Base Weak Base
acid base balance: part 1
acid base balance: part 1
STRENGTH OF ACID/BASE
Strength is defined in terms of the
tendency to donate (or accept) the
hydrogen ion to (from) the solvent
(i.e. water in biological systems)
SOURCES OF ACID / BASE IN
BODY FLUID
Endogenous source: Produced at
cellular level during metabolism
Exogenous source: Potentially
acidic/basic substances get entry in to
the body fluid through
enteral/parenteral route. i.e. via
1. Foods rich in acid (meat)
2. Ingestion of acids (salicylic acid)
3. Intravenous infusion
I) POTENTIAL SOURCES OF
VOLATILE ACID
Complete oxidation of glucose & FA
Oxidation of AA
II)POTENTIAL SOURCES OF
NON VOLATILE ACID
Oxidation of :
 basic AA : 130 mmol/Day
 S-containing AA: 70 mmol/Day
 PO4 containing subs: 30 mmol/Day
--------------------------------------------------------------
Total : 230 mmol/D
III) POTENTIAL SOURCES OF
BASE
Oxidation of acidic AA : 100 mmol/Day
Metabolism of dietary organic anions
(citrate/acetate) :60mmol/Day
---------------------------------------------------------------
Total = 160 mmol/D
AT A GLANCE, ACID& BASE
PRODUCTION IN 70 KG ADULT AT
NORMAL METABOLIC STATUS
 Volatile acid (CO2/H2CO3): 15-20 mol/D
 Non-volatile acid: 230 mmol/D
 Base: 160 mmol/D
CONTD
NVA & base neutralize each other at
one to one ratio. So, after
neutralization, 70 mmol/D NVA is left
behind (230-160 = 70)
This 70 mmol/D of NVA, along with
15-20 mol/D of volatile acid makes
the body env. acidic
JUSTIFY: OUR BODY IS NET
ACID PRODUCER
Although body produces both acids &
bases , in normal condition, rate of acid
production is higher than the rate of base
production.
So, normally body is regarded as net acid
producer producing net 15-20 mol/D of
volatile acid & 70 mmol/D of non-volatile
acid.
Body may be net base producer
pathologically
METABOLIC ACID OR BASE
PRODUCTION DEPENDS ON
Insulin status: Deficiency leads to acid
production
Blood flow / Oxygen supply to tissues:
Decreased flow/hypoxia leads to acid
production
Dietary habit: Protein generates more
acid, fruits generate more alkali,
vegetables generate less acid
ROUTES OF ACID/BASE
DISPOSAL
Respiratory Route Renal Route
High capacity
system, because,
dispose huge acid
load.
Low capacity system,
because, dispose
moderate acid load.
Excretes volatile
acids only
Excretes non-
volatile acids and
base as well
Unidirectional , i.e.
excrete only acid
Bidirectional , i.e.
excrete both acid &
base
CONTD
Respiratory Route Renal Route
Functional reserve
is up to 10-20 times
normal
Functional reserve
is up to 5-10 times
normal
Complete failure for
few minutes
reduces pH grossly
Complete failure for
few minutes has no
effect on pH at all.
ACIDITY OF A SOLUTION
State of H+
conc. of a solution.
Or
A measure of a solution’s capacity to
react with a strong base (usually
sodium hydroxide, NaOH) to a
predetermined pH value.
This measurement is based on the total
acidic constituent of a solution  
It is directly proportional to the acid
content & indirectly proportional to the
base/alkali content of the solution.
CONTD
It can be measured in :
Arithmetic scale: Has a definite
absolute unit and measures acidity by
exponential expression (10-7
mol/L) or
by decimal expression (0.001mol/L)
OR
 Logarithmic scale (pH scale): Has no
unit
EXPRESSION OF ACIDITY OF
BODY FLUID
In logarithmic
scale (pH)
In arithmetic scale
(H+
concentration
in nmol/L)
7.35 45
7.45 35
PH
OF A SOLUTION
Negative logarithm of hydrogen ion
concentration of a solution, when H+
concentration is expressed in terms of
mol/L
CONTD
If pH is 7.0 :
H+
concentration = 10-7
mol/L
= 10-7
x 109
= 100 nmol/L
CONTD
The less the pH, the more the
H+
concentration
&
vice-versa
THE ULTIMATE PH OF THE
BODY WILL DEPEND ON
CONTD
Normal blood pH: 7.35 – 7.45 (average
7.4)
 Arterial pH: 7.35-7.45
 Venous pH: 7.32-7.42
Clinically safe range of pH : 7.3 - 7.5
Normal H+
concentration of blood: 35 –
45 nmol/L
pH compatible to life: 6.8 – 7.8
pH at which life is impossible: >7.8 or
<6.8
acid base balance: part 1
PH SCALE
The pH scale measures how acidic or
basic a substance is.
It covers the practical range of acidity &
alkalinity of solutions commonly
encountered and it ranges from 0 to 14
A substance that is neither acidic nor
basic is neutral
ICF PH
ICF pH is slightly lower than that of
ECF/blood as cellular metabolism
produce acids. It is 7.0 – 7.3, though it
varies from cell to cell
Determined by the degree of cellular
metabolic function and tissue perfusion
CONTD
Changes in ECF pH causes parallel but
laser changes in ICF pH
Although it determines the cellular
activity, as it is difficult to measure ,
ECF pH is used for clinical evaluation,
which is easy to measure and nearly
reflects the ICF pH.
IMPORTANCE OF NORMAL
BODY PH
It supports optimum enzyme
activity for smooth running of
metabolism.
It is concerned with oxygen-Hb
dissociation & association
relationship as well as chemical
control of respiration.
CONTD
It maintains:
i. Native molecular form &
structural conformation of bio-
molecules, esp. protein, at which
they are functionally active.
ii. Internal environment and cellular
viability by tuning proper
electrolyte distribution in ECF via
Na+ _
K+
pump
iii. Optimum vascular resistance
WHY DOES LIFE THREATEN
BEYOND CLINICALLY SAFE
RANGE OF PH
There is Altered :
i. enzyme activity
ii.membrane permeability
iii.CNS activity
iv.electrolyte distribution
There is increased myocardial
irritability
There is decreased cellular
viability
IMPORTANT EFFECTS OF PH
CHANGE IN BODY
acid base balance: part 1
acid base balance: part 1
acid base balance: part 1
CONTD
H+ ions are very reactive cations
Proteins are anions at body pH
H+ ions at higher concentrations
can bind strongly to negatively
charged proteins, including
enzymes, and impair their activity
and hence the cell function.
acid base balance: part 1
acid base balance: part 1
acid base balance: part 1

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acid base balance: part 1

  • 1. ACID BASE BALANCE Dr. Ifat Ara Begum Assistant Professor Dept. of Biochemistry Dhaka Medical College Dhaka
  • 2. CLASS PLAN Basic facts: Repetition Regulation of acid base balance Pathophysiology of different acid base disorders
  • 3. DAY-1 Review on acid/base/pH/ buffers/ H-H Equation Origin of acids and bases in our body Acidity of solution pH & the effects of pH change
  • 4. ACIDS These are the molecules having hydrogen atom and can donate hydrogen ion ( H+ / Proton) in aqueous solution. In simple words: Acids are H+ / Protondonor
  • 5. HYDROGEN ATOM & HYDROGEN ION (PROTON)  Proton means hydrogen atom with its electron removed
  • 7. CONJUGATE BASE OF AN ACID Conjugate base of an acid is the anionic part of an acid after removal of proton from the acid
  • 8. C Rapidly & completely ionized in solution (body fluids) into H+ & its conjugate base. Degree of dissociation & dissociation constant is high pK value: Low Slowly & partially ionized in solution (body fluids) into H+ & its conjugate base. Degree of dissociation & dissociation constant is low pK value: High Strong Acid Weak Acid
  • 9. As conjugate base shows less affinity to H+, rapid and complete ionization to proton occurs. So, conjugate bases of strong acids are weak. Example: All inorganic acids except H2CO3 As conjugate base shows strong affinity to H+, slow and partial ionization to proton occurs. So, conjugate bases of weak acids are strong. Example: All organic acids and H2CO3 Strong Acid Weak Acid
  • 10. BASES These are the molecules that can accept H+ (Proton) in aqueous solution. In simple words, bases are H+ / Proton acceptor After accepting proton, conjugate acid of that base is formed. Bases may be charged like Cl- , HCO3 - or without charge like NH3
  • 12. C Have greater tendency to accept proton. Bind rapidly & strongly with proton, so, remove them quickly from solution Conjugate acid: weak Example: HCO3 - Have low tendency to accept proton. Bind slowly & weakly with proton, so, remove them slowly from solution Conjugate acid: strong Example: Cl- Strong Base Weak Base
  • 15. STRENGTH OF ACID/BASE Strength is defined in terms of the tendency to donate (or accept) the hydrogen ion to (from) the solvent (i.e. water in biological systems)
  • 16. SOURCES OF ACID / BASE IN BODY FLUID Endogenous source: Produced at cellular level during metabolism Exogenous source: Potentially acidic/basic substances get entry in to the body fluid through enteral/parenteral route. i.e. via 1. Foods rich in acid (meat) 2. Ingestion of acids (salicylic acid) 3. Intravenous infusion
  • 17. I) POTENTIAL SOURCES OF VOLATILE ACID Complete oxidation of glucose & FA Oxidation of AA
  • 18. II)POTENTIAL SOURCES OF NON VOLATILE ACID Oxidation of :  basic AA : 130 mmol/Day  S-containing AA: 70 mmol/Day  PO4 containing subs: 30 mmol/Day -------------------------------------------------------------- Total : 230 mmol/D
  • 19. III) POTENTIAL SOURCES OF BASE Oxidation of acidic AA : 100 mmol/Day Metabolism of dietary organic anions (citrate/acetate) :60mmol/Day --------------------------------------------------------------- Total = 160 mmol/D
  • 20. AT A GLANCE, ACID& BASE PRODUCTION IN 70 KG ADULT AT NORMAL METABOLIC STATUS  Volatile acid (CO2/H2CO3): 15-20 mol/D  Non-volatile acid: 230 mmol/D  Base: 160 mmol/D
  • 21. CONTD NVA & base neutralize each other at one to one ratio. So, after neutralization, 70 mmol/D NVA is left behind (230-160 = 70) This 70 mmol/D of NVA, along with 15-20 mol/D of volatile acid makes the body env. acidic
  • 22. JUSTIFY: OUR BODY IS NET ACID PRODUCER Although body produces both acids & bases , in normal condition, rate of acid production is higher than the rate of base production. So, normally body is regarded as net acid producer producing net 15-20 mol/D of volatile acid & 70 mmol/D of non-volatile acid. Body may be net base producer pathologically
  • 23. METABOLIC ACID OR BASE PRODUCTION DEPENDS ON Insulin status: Deficiency leads to acid production Blood flow / Oxygen supply to tissues: Decreased flow/hypoxia leads to acid production Dietary habit: Protein generates more acid, fruits generate more alkali, vegetables generate less acid
  • 24. ROUTES OF ACID/BASE DISPOSAL Respiratory Route Renal Route High capacity system, because, dispose huge acid load. Low capacity system, because, dispose moderate acid load. Excretes volatile acids only Excretes non- volatile acids and base as well Unidirectional , i.e. excrete only acid Bidirectional , i.e. excrete both acid & base
  • 25. CONTD Respiratory Route Renal Route Functional reserve is up to 10-20 times normal Functional reserve is up to 5-10 times normal Complete failure for few minutes reduces pH grossly Complete failure for few minutes has no effect on pH at all.
  • 26. ACIDITY OF A SOLUTION State of H+ conc. of a solution. Or A measure of a solution’s capacity to react with a strong base (usually sodium hydroxide, NaOH) to a predetermined pH value. This measurement is based on the total acidic constituent of a solution   It is directly proportional to the acid content & indirectly proportional to the base/alkali content of the solution.
  • 27. CONTD It can be measured in : Arithmetic scale: Has a definite absolute unit and measures acidity by exponential expression (10-7 mol/L) or by decimal expression (0.001mol/L) OR  Logarithmic scale (pH scale): Has no unit
  • 28. EXPRESSION OF ACIDITY OF BODY FLUID In logarithmic scale (pH) In arithmetic scale (H+ concentration in nmol/L) 7.35 45 7.45 35
  • 29. PH OF A SOLUTION Negative logarithm of hydrogen ion concentration of a solution, when H+ concentration is expressed in terms of mol/L
  • 30. CONTD If pH is 7.0 : H+ concentration = 10-7 mol/L = 10-7 x 109 = 100 nmol/L
  • 31. CONTD The less the pH, the more the H+ concentration & vice-versa
  • 32. THE ULTIMATE PH OF THE BODY WILL DEPEND ON
  • 33. CONTD Normal blood pH: 7.35 – 7.45 (average 7.4)  Arterial pH: 7.35-7.45  Venous pH: 7.32-7.42 Clinically safe range of pH : 7.3 - 7.5 Normal H+ concentration of blood: 35 – 45 nmol/L pH compatible to life: 6.8 – 7.8 pH at which life is impossible: >7.8 or <6.8
  • 35. PH SCALE The pH scale measures how acidic or basic a substance is. It covers the practical range of acidity & alkalinity of solutions commonly encountered and it ranges from 0 to 14 A substance that is neither acidic nor basic is neutral
  • 36. ICF PH ICF pH is slightly lower than that of ECF/blood as cellular metabolism produce acids. It is 7.0 – 7.3, though it varies from cell to cell Determined by the degree of cellular metabolic function and tissue perfusion
  • 37. CONTD Changes in ECF pH causes parallel but laser changes in ICF pH Although it determines the cellular activity, as it is difficult to measure , ECF pH is used for clinical evaluation, which is easy to measure and nearly reflects the ICF pH.
  • 38. IMPORTANCE OF NORMAL BODY PH It supports optimum enzyme activity for smooth running of metabolism. It is concerned with oxygen-Hb dissociation & association relationship as well as chemical control of respiration.
  • 39. CONTD It maintains: i. Native molecular form & structural conformation of bio- molecules, esp. protein, at which they are functionally active. ii. Internal environment and cellular viability by tuning proper electrolyte distribution in ECF via Na+ _ K+ pump iii. Optimum vascular resistance
  • 40. WHY DOES LIFE THREATEN BEYOND CLINICALLY SAFE RANGE OF PH There is Altered : i. enzyme activity ii.membrane permeability iii.CNS activity iv.electrolyte distribution There is increased myocardial irritability There is decreased cellular viability
  • 41. IMPORTANT EFFECTS OF PH CHANGE IN BODY
  • 45. CONTD H+ ions are very reactive cations Proteins are anions at body pH H+ ions at higher concentrations can bind strongly to negatively charged proteins, including enzymes, and impair their activity and hence the cell function.