Medication Description: Trisamin (Trisaminum)
Three- (hydroxymethyl) -aminomethane.
Synonyms: Triolamine, Pehanorm, THAM (Tris-Hydroxy-Amino-Methan), Trisaminol, Trisbuffer, etc.
A white crystalline powder with a slight odor of amines. Easily soluble in water. An aqueous solution is alkaline, 3, 66% aqueous solution is isosmotic to blood plasma; pH 10.2 - 10.7.
Trisamine is an antacid of systemic action. Possesses buffer properties. When administered intravenously, it reduces the concentration of hydrogen ions and increases the alkaline reserve of blood. Eliminates acidosis. In contrast to sodium bicarbonate, trisamine does not increase the CO 2 content of blood. The drug penetrates through the cell membrane and is able to eliminate intracellular acidosis. The drug also has an osmotic diuretic effect.
Excreted completely by the kidneys in unchanged form.
Trisamine is used for acute and chronic diseases accompanied by metabolic and mixed acidosis (shock, massive blood transfusions, extracorporeal circulation, burn, peritonitis, acute pancreatitis, etc.). Trisamine is indicated during resuscitation and in the post resuscitation period for the rapid elimination of acidosis. As a means of reducing acidosis and having a hypoglycemic effect, trisamine is prescribed in the treatment of diabetic acidosis. The drug is also indicated in the treatment of salicylate poisoning and hypnotic drugs derived from barbituric acid, since the osmodiuretic effect and alkalinization of urine promote the removal of weak acids from the body.
Assign intravenously in the form of 3, 66% solution; when taken orally, it does not affect the concentration of hydrogen ions in the blood, but acts as a strong laxative.
The average dose of a solution for a patient weighing 60 kg is 500 ml per hour (about 120 drops per minute). In order to avoid the development of side effects, the drug should not be administered at a high rate. Rapid administration can cause respiratory depression, a decrease in blood glucose, sodium ions and potassium. Rapid administration is allowed in exceptional cases (for example, to eliminate acidosis after a cardiac arrest), while up to 60 ml per minute is administered.
A more precise determination of the required amount of solution is made (if possible) by the Astrup method using the formula K = B x E, where K is the amount of 3,66% trisamine solution (ml), B is the base deficit (mmol / l), E is the patient's mass (kg)
The maximum dose of the drug should not exceed 1, 5 g / kg per day.
Trisamine can be re-administered not earlier than 48–72 h after the previous administration; if necessary, the introduction of earlier periods reduce the dose of the drug.
When using large doses of trisamine, it is recommended (in order to avoid reduction of electrolytes in the blood) to add sodium chloride at the rate of 1, 75 g and potassium chloride at the rate of 0.372 g per 1 liter of 3, 66% trisamine solution.