Details About Overdose or Poisoning Generic Salt ::  Thiamine, Thiamin, Vitamin B1

Thiamine (Thiamin, Vitamin B1)

    

Drug Pharmacology ::

I. Pharmacology. Thiamine (vitamin B1)is a water-soluble vitamin that acts as an essential cofactor forvarious pathways of carbohydrate metabolism. Thiamine also acts as acofactor in the metabolism of glyoxylic acid (produced in ethyleneglycol intoxication). Thiamine deficiency may result in beriberi andWernicke-Korsakoff syndrome. Thiamine is absorbed rapidly after oral,intramuscular, or intravenous administration. However, parenteraladministration is recommended for initial management of thiaminedeficiency syndromes.

Drug Indications ::

Indications

   

Empirictherapy to prevent and treat Wernicke-Korsakoff syndrome in alcoholicor malnourished patients. This also includes any patient presentingwith an altered mental status of unknown etiology. Thiamine should begiven concurrently with glucose in such patients.

Adjunctive treatment in patients poisoned with ethylene glycol to possibly enhance the detoxification of glyoxylic acid.

Drug Contra-Indications ::

III. Contraindications. Use caution in patients with known sensitivity to thiamine or preservatives.

Drug Adverse Effects ::

IV. Adverse effects

   

Anaphylactoidreactions, vasodilation, hypotension, weakness, and angioedema afterrapid intravenous injection. This may be attributable to the vehicle orcontaminates of thiamine preparations in the past; rare reaction withnew preparations.

Acute pulmonary edema in patients with beriberi owing to a sudden increase in vascular resistance.

Use in pregnancy. FDA category A for doses up to the recommended daily allowance (RDA) and category C for pharmacologic doses (see Table III–1).

Drug Lab Interactions ::

Drug or laboratory interactions. Theoretically, thiamine may enhance the effect of neuromuscular blockers, although the clinical significance is unclear.

Drug Dose Management ::

Dosage and method of administration. Parenteral,100 mg (children, 50 mg) slow IV (over 5 minutes) or IM; may repeatevery 8 hours at doses of 5–100 mg. For Wernicke’s encephalopathy,follow with daily parenteral doses of 50–100 mg until the patient istaking a regular diet. Doses as high as 1 g over the first 12 hourshave been given to patients with acute Wernicke-Korsakoff syndrome.

Drug Chemical Formulations ::

Formulations

   

Parenteral. Thiamine hydrochloride (various), 100 mg/mL, in 1- and 2-mL Tubex and multiple-dose vials (vials may contain benzyl alcohol).

The suggested minimum stocking level to treat a 70-kg adult for the first 24 hours is 1 g (five 2-mL multiple-dose vials or the equivalent).

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