Dosing & Uses
Dosage Forms & Strengths
infusion solution
- 0.3M (18 g)
Metabolic Acidosis
No longer available in the United States
IV dosage estimation: Tromethamine solution (mL of 0.3 M) required = Body Weight (kg) x Base Deficit (mEq/L) x 1.1 given by IV infusion
Dosage Forms & Strengths
IV solution
- 0.3M (18 g)
Metabolic Acidosis Associated with RDS
No longer available in the United States
1 mL/kg for each drop in pH below 7.4; determine additiona doses through changes in pH, PaO2, and pCO2
Adverse Effects
Frequency Not Defined
Alkalosis
Hypervolemia
Venospasm
Hyperkalemia
Hypoglycemia (usu doses >500 mg/kg over <1hr)
Hepatic necrosis (resulted during delivery via umbilical venous catheter)
Necrosis with extravasation
Phlebitis
Tissue irritation
Apnea
Pulmonary edema
Respiratory depression
Warnings
Contraindications
Uremia
Anuria
Neonates: chronic respiratory acidosis, salicylate intoxication
Cautions
Renal impairment
Extravasation may cause inflammation & tissue necrosis
Administer slowly to avoid alkalosis
Risk of overhydration, that may cause serum electrolyte dilution, pulm edema, CHF
Risk of hypoglycemia with extremely large doses
Pregnancy & Lactation
Pregnancy Category: C
Lactation: not known if present in breast milk, use caution
Pregnancy Categories
A:Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B:May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.
C:Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.
D:Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.
X:Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.
NA:Information not available.
Pharmacology
Mechanism of Action
Corrects acidosis by acting as a proton acceptor; releases bicarbonate buffer to correct acidosis by combining with hydrogen ions
Pharmacokinetics
Distribution: Distributes into cellular extracellular space quickly; at steady state distributes into a volume slightly greater than total body water; penetrates slowly intracellularly
Half-life: 5.6 hr
Excretion: Urine within 8 hr (>75%)
Administration
IV Administration
Slow intravenous infusion, by addition to pump-oxygenator ACD blood or other priming fluid or by injection into ventricular cavity during cardiac arrest
If infused into peripheral vein, use large needle in largest antecubital vein or indwelling catheter placed in large vein of an elevated limb to minimize chemical irritation of alkaline solution
Catheters recommended.
Storage
Contains no preservatives/antibacterials; discard unused portion
