Generic Name

Tromethamine

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Classification

FDA Approved Indications

• Used as a pH buffer in metabolic acidosis and in certain blood transfusion procedures

Mechanism of Action

Tromethamine (Tham) acts as a proton acceptor, buffering excess hydrogen ions in the blood to help correct acid-base disturbances, primarily metabolic acidosis.

Dosage and Administration

Adult: Dosage varies based on clinical condition; typically administered intravenously as directed by a healthcare professional.

Pediatric: Use is based on individual clinical assessment, dosing calculations should consider age and weight.

Geriatric: Adjust doses carefully considering renal function and overall health status.

Renal Impairment: Use cautiously; dosage adjustments may be necessary due to altered clearance.

Hepatic Impairment: No specific adjustments; use with caution.

Pharmacokinetics

Absorption: Not applicable (administered IV)

Distribution: Distributed in extracellular fluid; crosses the blood-brain barrier

Metabolism: Limited metabolism; primarily acts as a buffer

Excretion: Renally excreted as unchanged drug and metabolites

Half Life: Various, generally a few hours depending on renal function.

Contraindications

• Metabolic or respiratory alkalosis; hypersensitivity to tromethamine.

Precautions

• Use with caution in patients with renal impairment, heart failure, or edema due to risk of fluid overload.

Adverse Reactions - Common

• Electrolyte imbalance (e.g., hypernatremia, hyperkalemia) (Uncommon)
• Edema or fluid overload (Uncommon)

Adverse Reactions - Serious

• Alkalosis (Rare)
• Cardiac arrhythmias, especially in susceptible individuals (Rare)

Drug-Drug Interactions

• Caution with other alkalizing agents or medications affecting electrolyte balance.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Patient/Family Teaching

• Report signs of fluid overload (e.g., swelling, shortness of breath).
• Follow medical instructions carefully regarding dosing and administration.

Special Considerations

Black Box Warnings:

• Use cautiously in patients at risk for alkalosis or electrolyte imbalance.

Genetic Factors: N/A

Lab Test Interference: Can alter serum electrolyte measurements and blood pH readings.

Overdose Management

Signs/Symptoms: Metabolic alkalosis, hypokalemia, hypernatremia, fluid overload.

Treatment: Discontinue drug, provide supportive care, correct electrolyte disturbances, administer diuretics if necessary.

Storage and Handling

Storage: Store at room temperature, away from moisture and light.

Stability: Stable under recommended storage conditions.