Sections
Thiamine (Vitamin B1)
Description
Thiamine combines with ATP to form thiamine pyrophosphate coenzyme, a necessary component for carbohydrate metabolism. Most vitamins required by the body are obtained through diet, but certain states, such as alcoholism and malnutrition, may affect the intake, absorption, and use of thiamine. The brain is extremely sensitive to thiamine deficiency.
Onset & Duration
Onset: Rapid
Duration: Depends on degree of deficiency
Indications
1. Coma of unknown origin (before the administration of dextrose 50%, or Naloxone)
2. Delirium tremens
3. Beriberi (rare)
4. Wernicke's encephalopathy
5. Anemia from thiamine deficiency
Contraindications
1. There are not significant drug interactions with other emergency medications.
Adverse Reactions
1. Hypotension (from rapid injection or large dose)
2. Anxiety
3. Diaphoresis
4. Nausea and vomiting
5. Allergic reaction (usually form IV injection; very rare)
Drug Interactions
1. Hypersensitivity
2. There are no significant drug interactions with other emergency medications.
Special Considerations
1. Pregnancy safety: Category A
2. Large IV doses may cause respiratory difficulties
3. Anaphylactic reactions have been reported
4. It should be given before D50 in a comatose patient suspected of Wernicke's
encephalopathy
