Drug Guide
Thiamine Hydrochloride
Classification
Therapeutic: Vitamin B1 supplement, deficiency treatment
Pharmacological: Water-soluble vitamin
FDA Approved Indications
- Thiamine deficiency, including beriberi and Wernicke-Korsakoff syndrome, and prevention of deficiency in malnourished or alcohol-dependent patients
Mechanism of Action
Thiamine is a coenzyme involved in carbohydrate metabolism, facilitating the conversion of pyruvate to acetyl-CoA and supporting neuronal function.
Dosage and Administration
Adult: Typically 50-100 mg daily IM, IV, or oral as prescribed based on deficiency severity.
Pediatric: Dosage varies based on age and clinical condition; usually 5-25 mg daily oral or parenterally.
Geriatric: Adjust doses based on clinical response and renal function.
Renal Impairment: Adjustments needed; monitor for deficiency or toxicity.
Hepatic Impairment: Generally safe, but clinical monitoring recommended.
Pharmacokinetics
Absorption: Rapidly absorbed from gastrointestinal tract when taken orally.
Distribution: Wide distribution; crosses blood-brain barrier.
Metabolism: Minimal hepatic metabolism.
Excretion: Excreted primarily via urine.
Half Life: 0.5-1 hour.
Contraindications
- Known hypersensitivity to thiamine or any component of the formulation.
Precautions
- Use cautiously in patients with history of hypersensitivity reactions. Monitor for anaphylactic reactions, especially with IV administration. Use with caution in renal impairment; dose adjustment may be necessary.
Adverse Reactions - Common
- Allergic reactions, including redness, swelling, or rash (rare)
Adverse Reactions - Serious
- Anaphylactic reactions during IV administration (very rare)
Drug-Drug Interactions
- None significant, but caution with intravenous amino acids or other infusions.
Drug-Food Interactions
- Generally no significant food interactions.
Drug-Herb Interactions
- Limited data; always consider potential interactions
Nursing Implications
Assessment: Monitor for signs of deficiency, allergic reactions during infusion.
Diagnoses:
- Risk for deficient knowledge regarding supplementation.
- Risk for allergic reaction during IV administration.
Implementation: Administer as prescribed, preferably via IM or IV for deficiency states, or orally as directed.
Evaluation: Assess for resolution of deficiency symptoms and any adverse reactions.
Patient/Family Teaching
- Encourage adherence to prescribed dosing.
- Report signs of allergic reactions immediately.
- Explain purpose of supplementation.
Special Considerations
Black Box Warnings:
- None
Genetic Factors: Genetic polymorphisms are not typically relevant.
Lab Test Interference: No significant interference with laboratory tests.
Overdose Management
Signs/Symptoms: Rare, but large doses can cause hypersensitivity reactions.
Treatment: Discontinue use; supportive care; in case of allergic reactions, administer antihistamines or epinephrine as needed.
Storage and Handling
Storage: Store at room temperature, protected from light and moisture.
Stability: Stable when stored properly; expiration date should be checked.