Trometamol (Tromethamolum)

Pharmacodynamics Pharmacokinetics Indications Carefully Contraindications Dosing and Administration Side effects
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Clinical and pharmacological group: & nbsp

Regulators of water-electrolyte balance and KHS

Included in the formulation
АТХ:

B.05.X.X   Other additives to solutions for intravenous administration

B.05.X.X.02   Trometamol

Pharmacodynamics:

Change in the buffer capacity of blood (decrease in the concentration of H+ and an increase in the alkaline reserve of blood). Increase in osmotic pressure in the intestine (with ingestion), urine. Inhibition of precipitation of urinary stones (as trometamol citrate).

Pharmacokinetics:

Elimination of the kidneys in an unchanged form.

Indications:

Diseases accompanied by metabolic or mixed acidosis (shock, massive blood transfusion, extracorporeal circulation, burns, peritonitis, acute pancreatitis), during resuscitation in the postoperative period to the rapid elimination of acidosis, diabetic ketoacidosis, poisoning by salicylates and hypnotics, barbiturates, methyl alcohol .

ICD-10

IV.E70-E90.E87.2   Acidosis

XI.K65-K67.K65.0   Acute peritonitis

XI.K80-K87.K85   Acute pancreatitis

XVIII.R50-R69.R57.0   Cardiogenic shock

XVIII.R50-R69.R57.1   Hypovolemic shock

XVIII.R50-R69.R57.8   Other types of shock

XIX.T20-T32.T30   Thermal and chemical burns, unspecified

XIX.T36-T50.T42.3   Poisoning with barbiturates

XIX.T51-T65.T51   Toxic effect of alcohol

Contraindications:

Hypersensitivity, severe renal insufficiency, hypokalemia, chronic respiratory acidosis; children's age (up to one year); anuria, uremia, or kidney disease.

Carefully:

Moderate renal and / or hepatic insufficiency. Patients with insufficient ventilation should be administered only under conditions of controlled or auxiliary respiration. It is not recommended to appoint patients with isolated respiratory acidosis. In patients with respiratory acidosis, accompanied by metabolic acidosis, it is necessary to provide mechanical ventilation of the lungs.

Pregnancy and lactation:

Adequate and well-controlled studies in humans and animals have not been conducted. There is no information on the penetration into breast milk.

Category of recommendations for FDA is not defined.

Dosing and Administration:The average dose for a patient with a body weight of 60 kg is 500 ml / h (about 120 drops per minute). The maximum dose is 1.5 g / kg per day.

Re-introduction - not earlier than 48-72 hours after the previous; if it is necessary to introduce at an earlier time, the dose should be reduced.

In order to avoid a decrease in the concentration of electrolytes in the blood with the use of high doses, it is recommended to add an isotonic solution of sodium chloride at the rate of 1.75 g and potassium chloride at the rate of 0.372 g per liter of 3.66% solution.

At a risk of hypoglycemia, it is also recommended to inject 5-10% dextrose solution with insulin (1 unit of insulin per 4 g of dry dextrose).

Side effects:

With a rapid introduction: depression of the respiratory center, lowering of blood pressure, hypoglycemia, hyponatremia, hypokalemia.

Local reactions: venous disease, phlebitis.

Overdose:

Symptoms: depression of the respiratory center, hypoglycemia, reduction of blood pressure, nausea, vomiting.

Treatment: symptomatic.

Interaction:

Narcotic analgesics, aminoglycosides, macrolides (erythromycin, oleandomycin), chloramphenicol, tricyclic antidepressants - enhancing their effect.

Indirect anticoagulants (coumarin derivatives), barbiturates, salicylates - a weakening of their effect.

Special instructions:

Antiacidotic means of systemic action.

1 ml of a 7.2% solution (2 ml of a 3.6% solution) is equivalent to 1 mmol of sodium bicarbonate.

Unlike sodium bicarbonate does not increase the concentration of CO2 in blood.

It is mandatory to monitor the glucose and blood electrolytes, acid-base state.

To avoid the development of side effects should be administered slowly. Rapid administration (up to 60 ml / min) is permissible in exceptional cases (cardiac arrest).

When ingestion is not absorbed, it acts as a salt laxative.

It is an organic amine acceptor of protons; are used as a alkalizing agent for the treatment of metabolic acidosis.

Acts as a weak osmotic diuretic.

They are used mainly in cardiac bypass operations (including to reduce the acidity of citrated blood in shunting operations).

Dosing depends on body weight and base deficiency, to increase the pH of the blood to normal values, the minimum required dose should be administered (intravenously slowly in the form of 0.3 M solution).

Do not administer for longer than one day (other than life-threatening conditions).

Trometamol citrate is prescribed internally for the treatment of urinary stones and acidosis. Trometamol acephillinate is also used in acidosis.

Instructions
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