Description of the medicine: Trisaminum (Trisaminum)

TRISAMINE (Trisaminum).

Tri- (hydroxymethyl) -aminomethane.

Synonyms: Triolamine, Pehanorm, THAM (Tris-Hydroxy-Amino-Methan), Trisaminol, Trisbuffer and others.

White crystalline powder with a slight smell of amines. Easily soluble in water. The aqueous solution has an alkaline reaction, 3.66% aqueous solution is iso-osmotic with blood plasma; PH 10.2 - 10.7.

Trisamine is an antacid of systemic action. It has buffer properties. With intravenous administration reduces the concentration of hydrogen ions and increases the alkaline reserve of blood. Eliminates acidosis. Unlike sodium bicarbonate, trisamine does not increase the CO 2 content of the blood. The drug penetrates through the cell membrane and is able to eliminate intracellular acidosis. The drug also has an osmotic diuretic effect.

It is excreted completely by the kidneys in unmodified form.

Apply trisamine in 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 postresuscitation period for rapid elimination of acidosis. As a means of reducing acidosis and having a hypoglycemic effect, trisamine is prescribed for the treatment of diabetic acidosis. The drug is also indicated in the treatment of poisoning with salicylates and hypnotics, derivatives of barbituric acid, as the osmodiuretic effect and alkalinization of urine contribute to the removal of weak acids from the body.

Assign intravenously in the form of 3, 66% solution; When administered orally, the effect on the concentration of hydrogen ions in the blood does not, but acts as a strong laxative.

The average dose of the solution for a patient weighing 60 kg is 500 ml per hour (about 120 drops per minute). To avoid the development of side effects, to enter the drug at high speed should not be. Rapid administration may cause respiratory depression, a decrease in blood glucose, sodium and potassium ions. Rapid administration is allowed in exceptional cases (for example, to eliminate acidosis after cardiac arrest), and inject up to 60 ml per minute.

A more accurate determination of the required amount of solution is made (if possible) by Astrup's method according to the formula K = B x E, where K is the amount of 3, 66% trisamine solution (ml), B - base deficiency (mmol / L), E - patient weight (Kg).

The maximum dose of the drug should not exceed 1.5 g / kg per day.

Repeated trisamine can be administered no earlier than 48 to 72 hours after the previous administration; If it is necessary to introduce at an earlier time, reduce the dose of the drug.

When using large doses of tricamine, it is recommended (in order to avoid a decrease in the content 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 L 3, 66% solution of trisamine.