Trimethobenzamide Hydrochloride
(trye-meth-oh-ben′za-mide)
Tigan
Classification: ANTIEMETIC
Therapeutic: ANTIEMETIC
Prototype: Prochlorperazine
Pregnancy Category: C
AVAILABILITY
Capsule; solution for injection
ACTION & THERAPEUTIC EFFECT
Primary locus of action is thought to be the
chemoreceptor trigger zone (CTZ) in medulla. Less effective than phenothiazine antiemetics but produces fewer
adverse effects.
USES
Control of nausea and vomiting.
CONTRAINDICATIONS
Uncomplicated vomiting in viral illness;
parenteral use in children or infants; rectal administration in prematures and
newborns; known sensitivity to benzocaine (in suppository) or to similar local anesthetics.
CAUTIOUS USE
In presence of high fever, dehydration,
electrolyte imbalance; pregnancy (category C), lactation; children.
ROUTE & DOSAGE
Nausea and Vomiting
Adult: PO 300 mg t.i.d. or q.i.d. IM 200 mg
t.i.d. or q.i.d. prn
Geriatric: May require dose reduction or changes in
interval.
ADMINISTRATION
Oral
- Empty capsule and give with water or mix with
food if patient cannot swallow capsule.
Intramuscular
- Give IM deep into upper outer quadrant of
buttock.
- Minimize possibility of irritation and pain by
avoiding escape of solution along needle track. Use Z-track technique. Rotate
injection sites.
ADVERSE EFFECTS (≥1%)
Body as a Whole: Hypersensitivity reactions (including allergic skin eruptions),
muscle cramps, pain, stinging, burning, redness, irritation at IM site; local irritation following rectal administration. CNS: Pseudoparkinsonism. CV: Hypotension. GI:
Diarrhea, exaggeration of
nausea, acute hepatitis, jaundice.
INTERACTIONS
Drug: Alcohol and other CNS DEPRESSANTS add to depressant activity; PHENOTHIAZINES may precipitate extrapyramidal syndrome.
PHARMACOKINETICS
Onset: 10–40 min PO; 15 min IM. Duration: 3–4 h PO; 2–3 h IM. Elimination: 30–50% of dose excreted unchanged in urine
within 48–72 h.
NURSING IMPLICATIONS
Assessment & Drug Effects
- Monitor BP. Hypotension may occur particularly
in surgical patients receiving drug parenterally.
- Report promptly and stop drug therapy if an
acute febrile illness accompanies or begins during therapy.
- Antiemetic effect of drug may obscure diagnoses
of GI or other pathologic conditions or signs of toxicity from other drugs.
Patient & Family Education
- Report promptly to prescriber onset of rash or other
signs of hypersensitivity (see Appendix F). Discontinue drug immediately.
- Do not drive or engage in potentially hazardous
activities until response to drug is known.
- Do not drink alcohol or alcoholic beverages
during therapy with this drug.
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