Tham Disease Interactions

The use of tromethamine is contraindicated in patients with chronic respiratory acidosis. Tromethamine decreases carbon dioxide tension resulting in depressed ventilation.

The use of tromethamine is contraindicated in patients with severe renal impairment (anuria, uremia) and should be administered with caution in patients with renal dysfunction. Tromethamine may accumulate in patients with renal impairment as it is not appreciably metabolized and is primarily eliminated by the kidney. Hyperkalemia may result due to tromethamine use in patients with compromised renal function. Clinical monitoring of renal function and electrolyte levels is recommended.

Alkalinizing agents act as proton acceptors and/or dissociate to provide bicarbonate ions. Elimination of bicarbonate is decreased in patients with renal impairment and can result in metabolic alkalosis. Symptoms of metabolic alkalosis include hyperirritability or tetany, arrhythmia, and/or seizures (altered pH = altered calcium), or lactic acidosis due to impaired oxygen release. Therapy with alkalinizing agents should be administered with extreme caution in patients with compromised renal function. Clinical monitoring of renal function, acid/base balance and electrolytes is recommended.

Dose-related changes in blood glucose concentrations resulting in hypoglycemia have occurred during administration of tromethamine. Rapid infusion of tromethamine has also resulted in prolonged hypoglycemia. Therapy with tromethamine should be administered cautiously in patients with diabetes and temporary dosage modification of antihyperglycemic agents may be necessary.