II. Indications

III. Mechanism

  1. Weak base binds Hydrogen Ions and excreted renally

IV. Effects

  1. Unlike Sodium Bicarbonate which relies on CO2 exhalation to correct Metabolic Acidosis, THAM is renally excreted
    1. THAM may be preferred over Sodium Bicarbonate in the non-ventilated patient with Respiratory Acidosis
  2. Unlike Sodium Bicarbonate which lowers Serum Potassium, THAM does not alter Potassium levels
  3. Unlike Sodium Bicarbonate which increases Serum Sodium, THAM lowers Serum Sodium

V. Dosing

  1. Dose = wtKg x baseDeficit x 1.1

VI. Precautions

  1. Avoid acidosis over-correction

VII. Efficacy

  1. As with Sodium Bicarbonate, no evidence of outcome benefit in correction of Metabolic Acidosis

VIII. Adverse effects

IX. References

  1. Lin and Geier in Herbert (2016) EM:Rap 16(1):14-5
  2. Hoste (2005) J Nephrol 18(3): 303-7 +PMID:16013019 [PubMed]

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Ontology: Tromethamine (C0041175)

Definition (NCI) A member of the pyrrolo-pyrrole group of non-steroidal anti-inflammatory drugs (NSAID) with analgesic, anti-inflammatory, and anti-pyretic properties. Tromethamine inhibits both isoforms of cyclooxygenases (COX1 and COX2), thereby blocking the conversion of arachidonic acid to pro-inflammatory pro-prostaglandins. When inhibiting COX2, tromethamine may be effective in relieving pain and inflammation; when inhibiting COX1, this agent may produce unacceptable gastrointestinal side effects.
Definition (MSH) An organic amine proton acceptor. It is used in the synthesis of surface-active agents and pharmaceuticals; as an emulsifying agent for cosmetic creams and lotions, mineral oil and paraffin wax emulsions, as a biological buffer, and used as an alkalizer. (From Merck, 11th ed; Martindale, The Extra Pharmacopoeia, 30th ed, p1424)
Concepts Organic Chemical (T109) , Pharmacologic Substance (T121)
MSH D014325
SnomedCT 404882002, 59034000
LNC LP19244-0, MTHU007766
English Tris Buffer, Trisamine, Trometamol, Tromethamine, 1,3-Propanediol, 2-amino-2-(hydroxymethyl)-, Tri(hydroxymethyl)aminomethane, Tris(hydroxymethyl)aminomethane, TRIS, Aminotrimethylolmethane, Tris(hydroxymethyly)amino Methane, Tris-base, 1,3-Propanediol, 2-Amino-2-(hydroxymethyl)-, tromethamine, Abbott Brand of Trometamol, Trometamol Abbott Brand, Tham, hematological agents alkalinizers tromethamine, tromethamine (medication), TROMETHAMINE, Tromethamine [Chemical/Ingredient], tris buffer, Tromethamine (TRIS), trometamol, Tris buffer, Tromethamine (substance), Tromethamine (product)
Swedish Trometamin
Czech tromethamin
Finnish Tris-(hydroksimetyyli)-aminometaani
French Trométamol, Tham, Tri hydroxy-méthyl-aminométhane, Tampon Tris, Trométhamine, Tris(hydroxyméthyl)aminométhane
Japanese トリスアミン, トリメチロールアミノメタン, トリズマ, トリス緩衝液, トロメタミン, トロメタモール
Polish THAM, Talatrol, Trometamol
Portuguese Tampão Tris, Buffer Tris, Trisamina, Trometamina, Trometamol
Spanish tri-buffer, tris (hidroximetil)aminometano, tri (hidroximetil)aminometano, tri-amortiguador, trometamina (sustancia), trometamina, tris-amortiguador, trometamina (producto), trometamol (sustancia), trometamol, Trisamina, Tris Buffer, Trometamina, Trometamol
German Tris-Puffer, Trisamin, Trometamol, Tromethamin
Italian Trometamina