Thiamine

Question 1

Trade Name

Answer 1

Betalin S

Question 2

Class

Answer 2

Vitamin B1

Question 3

Mechanism of action

Answer 3

Combines with ATP to form thiamine pyrophosphate coenzyme, a necessary component for carbohydrate metabolism (the brain is extremely sensitive to thiamine deficiency)

Question 4

Indications

Answer 4

Coma of unknown origin, delirium tremens, beriberi, Wernickes encephalopathy

Question 5

Contraindications

Answer 5

Do not give intra-arterial

Question 6

Precautions

Answer 6

Give thiamine before administering glucose under all circumstances

Question 7

Adverse Effects

Answer 7

Hypotension (rare) from rapid administration or from too high a dose

Question 8

Incompatibilities/drug interactions

Answer 8

Administer thiamine before glucose in alcoholics, starved or malnourished patients

Question 9

Routes of Admin

Answer 9

IM, IV/IO

Question 10

Onset of action

Answer 10

Rapid onset, peak effects variable and duration is dependent on degree of deficiency

Question 11

Adult dose

Answer 11

200mg slow IVP, IM if unable to obtain IV

Question 12

Pediatric dose

Answer 12

N/A

Question 13

Special consideration

Answer 13

In the known alcoholic patient; Dextrose should not be administered without administering Thiamine first.
Large IV doses may cause respiratory difficulties, anaphylactic reactions have been reported.

Question 14

Protocols used

Answer 14

A-5: Chest pain
A-6: CHF
A-6b: CPAP
A-7: Cariogenic shock
A-8: Asystole/PEA
A-9: Bradyarrythmias
A-13: Diabetic emergencies
A-22: Overdose
A-24 carbon monoxide poisoning