Tigan


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Related to Tigan: timolol, Phenergan

Tigan

 [ti´gan]
trademark for preparations of trimethobenzamide hydrochloride, an antiemetic.

trimethobenzamide hydrochloride

Tigan

Pharmacologic class: Anticholinergic

Therapeutic class: Antiemetic

Pregnancy risk category C

Action

Unclear. Thought to block dopamine receptors and emetic impulses in chemoreceptor trigger zone, preventing nausea and vomiting.

Availability

Capsules: 300 mg

Injection: 100 mg/ml in 2-ml ampules and prefilled syringes and in 20-ml vials

Indications and dosages

Nausea and vomiting

Adults: 300 mg P.O. three to four times daily or 200 mg I.M. three to four times daily

Dosage adjustment

• Renal impairment

Contraindications

• Hypersensitivity to drug

• Parenteral form in children

Precautions

Use cautiously in:

• renal impairment, arrhythmias, encephalitis, gastroenteritis, dehydration, electrolyte imbalances

• concurrent alcohol use

• elderly or debilitated patients

• pregnant or breastfeeding patients

• children with known or suspected viral illnesses.

Administration

• In I.M. use, inject deep into upper outer quadrant of gluteus maximus.

• Withhold drug in children with signs or symptoms of Reye's syndrome.

Adverse reactions

CNS: drowsiness, dizziness, headache, depression, disorientation, parkinsonian symptoms, coma, seizures

CV: hypotension

EENT: blurred vision

Hematologic: blood dyscrasias

Hepatic: jaundice

Musculoskeletal: muscle cramps, opisthotonos

Skin: rash, urticaria, flushing

Other: pain and stinging at I.M. injection site, hypersensitivity reaction

Interactions

Drug-drug. Antidepressants, antihistamines, CNS depressants, opioids, sedative-hypnotics: additive CNS depression

Drug-behaviors. Alcohol use: additive CNS depression

Patient monitoring

• Monitor neurologic status, especially for parkinsonian symptoms and other serious adverse reactions.

• Assess CBC and liver function tests. Watch for blood dyscrasias and jaundice.

• Evaluate injection site for pain and stinging.

• Closely monitor patient's nutritional and hydration status. Report continuing nausea.

Patient teaching

• Advise patient to take as needed for nausea and vomiting, but only as prescribed.

• Tell patient to contact prescriber promptly if nausea persists despite therapy.

• Instruct patient to minimize nausea and vomiting by eating small, frequent servings of healthy food and drinking plenty of fluids.

• Advise patient to avoid alcohol.

• Caution patient to avoid driving and other hazardous activities until drug effects are known.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs and behaviors mentioned above.

trimethobenzamide

(trye-meth-oh-ben-za-mide) ,

Tigan

(trade name)

Classification

Therapeutic: antiemetics
Pharmacologic: anticholinergics
Pregnancy Category: C

Indications

Mild to moderate nausea and vomiting.

Action

Inhibits emetic stimulation of the chemoreceptor trigger zone in the medulla.

Therapeutic effects

Decreased nausea and vomiting.

Pharmacokinetics

Absorption: Complete absorption following oral and IM administration.
Distribution: Unknown.
Metabolism and Excretion: Metabolized by the liver; 30–50% excreted unchanged in urine.
Half-life: 7–9 hr.

Time/action profile (antiemetic effect)

ROUTEONSETPEAKDURATION
PO10–40 minunknown3–4 hr
IM15–35 minunknown2–3 hr

Contraindications/Precautions

Contraindicated in: Hypersensitivity.
Use Cautiously in: Pediatric: Children; Geriatric: Appears on Beers list. Potential for extrapyramidal side effects may outweigh potential benefit; Obstetric / Lactation: Safety not established.

Adverse Reactions/Side Effects

Central nervous system

  • coma (life-threatening)
  • seizures (life-threatening)
  • drowsiness (most frequent)
  • depression
  • extrapyramidal reactions

Cardiovascular

  • hypotension (most frequent)

Gastrointestinal

  • diarrhea
  • hepatitis

Dermatologic

  • rashes

Hematologic

  • blood dyscrasias

Local

  • pain (most frequent)
  • burning at IM injection site
  • redness at IM injection site
  • stinging at IM injection site

Interactions

Drug-Drug interaction

↑ CNS depression with other CNS depressants, including alcohol, antidepressants, antihistamines, opioid analgesics, and sedative/hypnotics.

Route/Dosage

Oral (Adults) 300 mg 3–4 times daily.
Intramuscular (Adults) 200 mg 3–4 times daily as needed.

Renal Impairment

(Adults) CCr ≤70 mL/min—↓ dose or ↑ dosing interval.

Availability (generic available)

Capsules: 300 mg
Injection: 100 mg/mL

Nursing implications

Nursing assessment

  • Assess patient for nausea and vomiting prior to and 30–60 min following administration.
  • Assess BP for hypotension following parenteral administration.

Potential Nursing Diagnoses

Risk for deficient fluid volume (Indications)
Risk for injury (Side Effects)

Implementation

  • Oral: Capsules can be opened and contents mixed with food or fluids for patients with difficulty swallowing.
  • Intramuscular: Inject deep into well-developed muscle mass to minimize tissue irritation.
    • Trimethobenzamide is not receommended for IV use.

Patient/Family Teaching

  • Instruct patient to take medication as directed. Take missed doses as soon as remembered unless almost time for next dose; do not double doses.
  • Advise patient to make position changes slowly to minimize orthostatic hypotension following parenteral doses.
  • May cause drowsiness. Caution patient to avoid driving or other activities requiring alertness until response to medication is known.
  • Caution patient to avoid taking alcohol or other CNS depressants concurrently with this medication.
  • Instruct patient to notify health care professional promptly if sore throat, fever, unusual weakness or tiredness, tremors, or yellowing of the skin and eyes occurs.

Evaluation/Desired Outcomes

  • Prevention and relief of nausea and vomiting.

Tigan

a trademark for an antiemetic (trimethobenzamide hydrochloride).
References in periodicals archive ?
Sundarapandian, "Output regulation of the Tigan system," International Journal on Computer Science & Engineering, vol.
The fate of the Tigan project was not immediately clear after Orascom withdrew from managing the development.
De aceea, denumirea de tigani o intalnim in cele mai multe limbi europene ca: tigan, zingari, tsigani, cigani, cikani, gitanos etc.
is the greatest true feeling possible" Joe Redden Tigan writes.
But Bridgend father and daughter Mark Morgan, 45, and 10-year-old Tigan said the tour's producers should offer fans a refund on their pounds 36 tickets, as all the advertised acts would not take to the stage.
Phenergan, Tigan, Compazine, Vistaril) provide considerable relief.
Waggle is a novel written by golf lover Joe Redden Tigan, for fellow golf lovers and suburbanites everywhere.
Tigan and other suppository drug products that contain trimethobenzamide hydrochloride have not been shown to be effective for nausea and vomiting and should no longer be marketed, according to the Food and Drug Administration.
Suppositories containing trimethobenzamide, a sedating antihistamine, have been used to treat nausea and vomiting in children and adults and have been marketed under trade names that include Tigan, Tebamide, T-Gen, Trimazide, and Trimethobenz.
The decision follows a 2005 letter from King saying it wouldn't pursue studies to prove the effectiveness of its version, called Tigan.
Trimethobenzamide HCI Amide Pharmaceutical Tigan capsules
The releases onto city streets drew down a well recently activated by the state, and caused low pressure throughout the city, said Leslie Tigan, city clerk.