TRIMETHOBENZAMIDE HYDROCHLORIDe (trye-meth-oh-ben'za-mide)
Tigan Classifications: antiemetic; Therapeutic:antiemetic Prototype: Prochlorperazine Pregnancy Category: C
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Availability
300 mg capsules; 100 mg/mL injection
Action
Antiemetic actions less effective than phenothiazine antiemetics but produces fewer adverse effects. Must be used with other
agents when vomiting is severe. Primary locus of action is thought to be the chemoreceptor trigger zone (CTZ) in medulla.
Therapeutic Effect
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; pregnancy (category C). Safe
use in lactation is not established.
Cautious Use
Patients who have recently received other centrally acting drugs; in presence of high fever, dehydration, electrolyte imbalance.
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
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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;
belladonna alkaloids may intensify anticholinergic effects;
phenothiazines may precipitate extrapyramidal
syndrome.
Pharmacokinetics
Onset: 1040 min PO; 15 min IM.
Duration: 34 h PO; 23 h IM.
Elimination: 3050% of dose excreted unchanged in urine within 4872 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 physician 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.