Tromethamine

Synonym :

THAM

Mechanism :

Acts as a proton acceptor, which combines with hydrogen ions, liberating bicarbonate buffer, to correct acidosis. Also, an osmotic diuretic.

Indication :

Correction of metabolic acidosis associated with cardiac bypass surgery or cardiac arrest.
To correct excess acidity of stored blood that is preserved with acid citrate dextrose.
Infants needing alkalinisation after receiving maximum sodium bicarbonate.

Contraindications :

Hypersensitivity to tromethamine or any component of the formulation; Uremia or anuria; Chronic respiratory acidosis (neonates); Salicylate intoxication (neonates).

Dosing :

Dose depends on buffer base deficit; when deficit is known: Tromethamine (ML of 0.3 molar [M] solution) = body weight (kg) x base deficit (MEq/L) x 1.1

Adverse Effect :

Alkalosis, localized phlebitis, venospasm, hyperkalemia, hypervolemia, hypoglycaemia, hepatic necrosis, apnea, pulmonary edema, respiratory depression.

Interaction :

Alpha-/Beta-Agonists (Indirect-Acting): Alkalinizing Agents may increase the serum concentration of Alpha-/Beta-Agonists.
Amphetamines: Alkalinizing Agents may decrease the excretion of Amphetamines.

Hepatic Dose :

No dose adjustment recommended.