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Pronunciation |
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(THYE
a
min) |
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Generic
Available |
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Yes |
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Canadian Brand
Names |
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Betaxin®; Bewon® |
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Synonyms |
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Aneurine Hydrochloride; Thiamine Hydrochloride; Thiaminium Chloride
Hydrochloride; Vitamin B1 |
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Pharmacological Index |
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Vitamin, Water Soluble |
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Use |
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Treatment of thiamine deficiency including beriberi, Wernicke's
encephalopathy syndrome, and peripheral neuritis associated with pellagra,
alcoholic patients with altered sensorium; various genetic metabolic
disorders |
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Pregnancy Risk
Factor |
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A/C (if dose exceeds RDA recommendation) |
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Contraindications |
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Hypersensitivity to thiamine or any component |
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Warnings/Precautions |
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Use with caution with parenteral route (especially I.V.) of
administration |
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Adverse
Reactions |
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<1%: Cardiovascular collapse and death, warmth, rash, angioedema,
paresthesia |
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Drug
Interactions |
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Neuromuscular blocking agents; high carbohydrate diets or I.V. dextrose
solutions increase thiamine requirement |
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Stability |
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Protect oral dosage forms from light; incompatible with alkaline or
neutral solutions and with oxidizing or reducing agents |
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Mechanism of
Action |
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An essential coenzyme in carbohydrate metabolism by combining with adenosine
triphosphate to form thiamine pyrophosphate |
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Pharmacodynamics/Kinetics |
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Absorption: Oral: Adequate; I.M.: Rapid and complete
Elimination: Renally as unchanged drug, and as pyrimidine after body storage
sites become saturated |
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Usual Dosage |
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Recommended daily allowance:
<6 months: 0.3 mg
6 months to 1 year: 0.4 mg
1-3 years: 0.7 mg
4-6 years: 0.9 mg
7-10 years: 1 mg
11-14 years: 1.1-1.3 mg
>14 years: 1-1.5 mg
Thiamine deficiency (beriberi):
Children: 10-25 mg/dose I.M. or I.V. daily (if critically ill), or 10-50
mg/dose orally every day for 2 weeks, then 5-10 mg/dose orally daily for 1 month
Adults: 5-30 mg/dose I.M. or I.V. 3 times/day (if critically ill); then
orally 5-30 mg/day in single or divided doses 3 times/day for 1 month
Wernicke's encephalopathy: Adults: Initial: 100 mg I.V., then 50-100 mg/day
I.M. or I.V. until consuming a regular, balanced diet
Dietary supplement (depends on caloric or carbohydrate content of the diet):
Infants: 0.3-0.5 mg/day
Children: 0.5-1 mg/day
Adults: 1-2 mg/day
Note: The above doses can be found in multivitamin preparations
Metabolic disorders: Oral: Adults: 10-20 mg/day (dosages up to 4 g/day in
divided doses have been used) |
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Dietary
Considerations |
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High carbohydrate diets may increase thiamine
requirement |
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Reference Range |
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Therapeutic: 1.6-4 mg/dL |
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Test
Interactions |
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False-positive for uric acid using the phosphotungstate method and for
urobilinogen using the Ehrlich's reagent; large doses may interfere with the
spectrophotometric determination of serum theophylline
concentration |
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Mental Health: Effects
on Mental Status |
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None reported |
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Mental Health:
Effects on Psychiatric
Treatment |
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None reported |
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Dental Health: Local
Anesthetic/Vasoconstrictor
Precautions |
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No information available to require special precautions |
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Dental Health:
Effects on Dental Treatment |
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No effects or complications reported |
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Patient
Information |
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Take exactly as directed; do not discontinue without consulting prescriber
(deficiency state can occur in as little as 3 weeks). Follow dietary
instructions (dietary sources include legumes, pork, beef, whole grains, yeast,
fresh vegetables). |
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Nursing
Implications |
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Single vitamin deficiency is rare; look for other
deficiencies |
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Dosage Forms |
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Injection, as hydrochloride: 100 mg/mL (1 mL, 2 mL, 10 mL, 30 mL); 200 mg/mL
(30 mL)
Tablet, as hydrochloride: 50 mg, 100 mg, 250 mg, 500 mg
Tablet, as hydrochloride, enteric coated: 20 mg |
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References |
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Doyon S and Roberts JR, "Reappraisal of the "Coma Cocktail": Dextrose,
Flumazenil, Naloxone, and Thiamine," Emerg Med Clin North Am, 1994,
12(2):301-16.
Hoffman RS and Goldfrank LR,
"The Poisoned Patient With Altered Consciousness. Controversies in the Use of a 'Coma Cocktail',"
JAMA, 1995, 274(7):562-9.
Petrie WM and Ban TA, "Vitamins in Psychiatry. Do They Have a Role?"
Drugs, 1985, 30(1):58-65.
Proebstle TM, Gall H, and Jugert FK,
"Specific IgE and IgG Serum Antibodies to Thiamine Associated With Anaphylactic Reaction,"
J Allergy Clin Immunol, 1995, 95(5 Pt 1):1059-60.
Reuler JB, Girard DE, and Cooney TG,
"Current Concepts: Wernicke's Encephalopathy," N Engl J Med, 1985,
312(16):1035-39.
Stephen JM, Grant R, and Veh CS,
"Anaphylaxis From Administration of Intravenous Thiamine," Am J Emerg
Med, 1992, 10(1):61-3.
Van Haecke P, Ramaekers D, Vanderwegen L, et al,
"Thiamine-Induced Anaphylactic Shock," Am J Emerg Med, 1995, 13(3):371-2.
Wrenn KD, Murphy F, and Slovis CM,
"A Toxicity Study of Parenteral Thiamine Hydrochloride," Ann Emerg Med,
1989, 18(8):867-70. |
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