Description of medicine: Trisaminum (Trisaminum)
Tri- (hydroxymethyl) -aminomethane.
Synonyms: Triolamine, Pehanorm, THAM (Tris-Hydroxy-Amino-Methan), Trisaminol, Trisbuffer, etc.
White crystalline powder with a slight odor of amines. Easily soluble in water. The aqueous solution has an alkaline reaction, 3, 66% aqueous solution is isosmotic to blood plasma; pH 10.2 - 10.7.
Trisamine is a systemic antacid. It has buffering properties. When administered intravenously, it reduces the concentration of hydrogen ions and increases the alkaline reserve of blood. Eliminates acidosis. Unlike sodium bicarbonate, trisamine does not increase blood CO 2 content. The drug penetrates through cell membranes and is able to eliminate intracellular acidosis. The drug also has an osmotic diuretic effect.
It is excreted completely by the kidneys unchanged.
Trisamine is used in acute and chronic diseases accompanied by metabolic and mixed acidosis (shock, massive blood transfusions, extracorporeal circulation, burns, peritonitis, acute pancreatitis, etc.). Trisamine is indicated during resuscitation and in the postresuscitative 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 poisoning with salicylates and hypnotics, derivatives of barbituric acid, since the osmodiuretic effect and alkalization of urine contribute to the removal of weak acids from the body.
Assign intravenously in the form of a 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 speed. Rapid administration can cause respiratory depression, a decrease in blood levels of glucose, sodium and potassium ions. Rapid administration is allowed in exceptional cases (for example, to eliminate acidosis after cardiac arrest), with up to 60 ml per minute.
A more accurate determination of the required amount of solution is carried out (if possible) by the Astrup method according to 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.
Repeatedly, trisamine can be administered no earlier than 48 to 72 hours after the previous injection; if necessary, introduction at an earlier date reduces the dose of the drug.
When using large doses of trisamine, it is recommended (in order to avoid a decrease in blood electrolytes) 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.