TRIMETHOBENZAMIDE HYDROCHLORIDE

TRIMETHOBENZAMIDE HYDROCHLORIDe
(trye-meth-oh-ben'za-mide)
Tigan
Classifications: antiemetic;
Therapeutic:antiemetic

Prototype: Prochlorperazine
Pregnancy Category: C

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

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: 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 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.

Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; Canadian drug name; Prototype drug

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