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Chemistry

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Also known as: Trometamol, 77-86-1, Tris, 2-amino-2-(hydroxymethyl)propane-1,3-diol, Tham, Trizma

Molecular Formula

C₄H₁₁NO₃

Molecular Weight

121.14 g/mol

InChI Key

LENZDBCJOHFCAS-UHFFFAOYSA-N

FDA UNII

023C2WHX2V

An organic amine proton acceptor. It is used in the synthesis of surface-active agents and pharmaceuticals; as an emulsifying agent for cosmetic creams and lotions, mineral oil and paraffin wax emulsions, as a biological buffer, and used as an alkalizer. (From Merck, 11th ed; Martindale, The Extra Pharmacopoeia, 30th ed, p1424)

1 2D Structure

Tromethamine API

2 Identification

2.1 Computed Descriptors

2.1.1 IUPAC Name

2-amino-2-(hydroxymethyl)propane-1,3-diol

2.1.2 InChI

InChI=1S/C4H11NO3/c5-4(1-6,2-7)3-8/h6-8H,1-3,5H2

2.1.3 InChI Key

LENZDBCJOHFCAS-UHFFFAOYSA-N

2.1.4 Canonical SMILES

C(C(CO)(CO)N)O

2.2 Other Identifiers

2.2.1 UNII

023C2WHX2V

2.3 Synonyms

2.3.1 MeSH Synonyms

1. Tri(hydroxymethyl)aminomethane

2. Tris Buffer

3. Tris-magnesium(ii)-potassium Chloride Buffer

4. Tris-mg(ii)-kcl Buffer

5. Trisamine

6. Trizma

7. Trometamol

2.3.2 Depositor-Supplied Synonyms

1. Trometamol

2. 77-86-1

3. Tris

4. 2-amino-2-(hydroxymethyl)propane-1,3-diol

5. Tham

6. Trizma

7. Trisamine

8. 2-amino-2-(hydroxymethyl)-1,3-propanediol

9. Tris Buffer

10. Tromethane

11. Tris-base

12. Trisaminol

13. 1,3-propanediol, 2-amino-2-(hydroxymethyl)-

14. Pehanorm

15. Talatrol

16. Trisamin

17. Trispuffer

18. Tutofusin Tris

19. Apiroserum Tham

20. Tris-steril

21. Addex-tham

22. Tris, Free Base

23. Trimethylolaminomethane

24. Tris Amino

25. Aminotrimethylolmethane

26. Aminotris(hydroxymethyl)methane

27. Tham-e

28. Tris (buffering Agent)

29. Tromethanmin

30. Tris(hydroxymethyl)methanamine

31. Tris(hydroxymethyl)methylamine

32. Trometamole

33. Trizma Base

34. 2-amino-2-methylol-1,3-propanediol

35. Tris-hydroxymethylaminomethane

36. Tri(hydroxymethyl)aminomethane

37. Tris-amino

38. Methylamine, 1,1,1-tris(hydroxymethyl)-

39. Nsc 6365

40. 2-(hydroxymethyl)-2-amino-1,3-propanediol

41. Trometamol [inn]

42. Methanamine, 1,1,1-tris(hydroxymethyl)-

43. Nsc-6365

44. Mfcd00004679

45. Bakerbond(tm) Cyano (cn)

46. 2-amino-2-hydroxymethyl-1,3-propanediol

47. 023c2whx2v

48. Chebi:9754

49. Tris(hydroxymethyl) Aminomethane

50. Abx (antibody Exchanger)

51. Tris-(hydroxymethyl)-aminomethane

52. Nsc6365

53. 1,1,1-tris(hydroxymethyl)methanamine

54. Tris (tromethamine)

55. 126850-03-1

56. 126850-06-4

57. 126850-08-6

58. Ncgc00159412-02

59. Ncgc00159412-04

60. Tris Buffertris-hydroxymethyl-aminomethan

61. Wp Quat (strong Anion Exchanger)

62. Tromethamolum

63. Dsstox_cid_3723

64. Trishydroxymethylaminomethane

65. Wln: Q1xz1q1q

66. Dsstox_rid_77165

67. Dsstox_gsid_23723

68. 126850-05-3

69. 136760-04-8

70. Amino (nh2) Narrow-pore Media-normal Phase

71. 4-anilino-1-(2-hydroxyethylamino)anthracene-9,11-dione

72. Tromethamine [usan]

73. (tris(hydroxymethyl)aminomethane)

74. [tris(hydroxymethyl)aminomethane]

75. Caswell No. 036

76. Trometamolum

77. 1, 2-amino-2-(hydroxymethyl)-

78. Triladyl

79. Trigmo Base

80. Mfcd00132476

81. Methanamine,1,1-tris(hydroxymethyl)-

82. Methylamine,1,1-tris(hydroxymethyl)-

83. Trometamolum [inn-latin]

84. Tris(hydroxymethyl)amino Methane

85. .beta.-d-ribo-hexopyranose, 1,6-anhydro-3-deoxy-2-o-(1-methylethyl)-4-o-(phenylmethyl)-

86. Cas-77-86-1

87. Tris(hydroxymethyl)aminomethane, >=99.8%

88. 2-amino-2-(hydroxymethyl)-1, 3-propanediol

89. Hsdb 3408

90. Einecs 201-064-4

91. Tris(hydroxymethyl)aminomethane, Electrophoresis Grade

92. Tris-mg(ii)-kcl Buffer

93. Tromethamine [usan:usp]

94. Epa Pesticide Chemical Code 083901

95. Tris-hydroxymethyl-aminomethan [german]

96. Unii-023c2whx2v

97. Trometamina

98. Tromethamin

99. Aminotri(hydroxymethyl)methane

100. Tribase

101. Tris-hydroxymethyl-aminomethan

102. Tris-buffer

103. Tris-amine

104. Ai3-03948

105. Tro.meta.mole

106. Tris(hydroxymethyl)-aminomethane

107. Tro.meta.mol

108. Tris(hydroxymethyly)amino Methane

109. 1gng

110. Tris Base Solution

111. Trs

112. Tromethamine (usp)

113. 1h4n

114. Trometamol (jan/inn)

115. Trometamol [jan]

116. Tromethamine [ii]

117. Tromethamine [mi]

118. Tris-magnesium(ii)-potassium Chloride Buffer

119. Schembl975

120. Trishydroxymethylmethylamine

121. Tham (tn)

122. Buffer Salt, Ph 10.5

123. Ec 201-064-4

124. Tromethamine [hsdb]

125. Tromethamine [inci]

126. Trometamol [mart.]

127. Nciopen2_000263

128. Nciopen2_001720

129. Trometamol [who-dd]

130. Tromethamine [vandf]

131. 2-amino-2-hydroxymethyl-1,3-propanediol Solution

132. Oprea1_677781

133. Trishydroxymethyl Aminomethane

134. Tris-hydroxymethyl-methylamine

135. Mls000028643

136. Tris Hydroxymethyl Aminomethane

137. Tromethamine [usp-rs]

138. Tris-(hydroxymethyl)methylamine

139. Tris (hydroxymethyl)aminoethane

140. Gtpl7328

141. Tris (hydroxymethyl)aminomethane

142. Chembl1200391

143. Dtxsid2023723

144. Tris (hydroxymethyl) Methylamine

145. Tris (hydroxymethyl) Aminomethane

146. Trometamol [ep Monograph]

147. Trometamol(tris),proteomics Grade

148. 2-amino-2-hydroxymethylpropanediol

149. Hms3652l05

150. Hms3885h09

151. Tris-(hydroxymethyl)-amino-methane

152. Tromethamine [orange Book]

153. Zinc896695

154. 2-amino-2-hydroxymethyl-propane-1

155. Tris-base, Molecular Biology Grade

156. Bcp05578

157. Hy-d0227

158. Nsc65434

159. Str03166

160. Tham-e Component Tromethamine

161. Tox21_111645

162. Tox21_201646

163. Tox21_303167

164. Tromethamine [usp Monograph]

165. Bbl000011

166. Nsc-65434

167. S4176

168. Stk379529

169. 2-amino-2-methylol-propane-1,3-diol

170. Akos000121321

171. Tox21_111645_1

172. Trometamol(tris),for Molecular Biology

173. Am90366

174. Ccg-214012

175. Cs-w018524

176. Db03754

177. Pb47623

178. Trizma(r) Base, >=99.0% (t)

179. Atx Tris Buffer, Ready-to-use Solution

180. Tris(hydroxymethyl)aminomethane, >=99%

181. Tromethamine Component Of Tham-e

182. Ncgc00159412-03

183. Ncgc00159412-05

184. Ncgc00257164-01

185. Ncgc00259195-01

186. Tris, 0.5m Buffer Solution, Ph 6.8

187. Tris, 0.5m Buffer Solution, Ph 7.2

188. Tris, 0.5m Buffer Solution, Ph 7.4

189. Tris, 0.5m Buffer Solution, Ph 7.5

190. Tris, 0.5m Buffer Solution, Ph 8.0

191. Tris, 0.5m Buffer Solution, Ph 8.5

192. Tris, 0.5m Buffer Solution, Ph 8.6

193. Tris, 0.5m Buffer Solution, Ph 8.8

194. Tris, 0.5m Buffer Solution, Ph 9.0

195. Tris, 0.5m Buffer Solution, Ph 9.5

196. Tris, 1.0m Buffer Solution, Ph 6.5

197. Tris, 1.0m Buffer Solution, Ph 7.4

198. Tris, 1.0m Buffer Solution, Ph 7.6

199. Tris, 1.0m Buffer Solution, Ph 7.8

200. Tris, 1.0m Buffer Solution, Ph 8.0

201. Tris, 1.0m Buffer Solution, Ph 8.2

202. Tris, 1.0m Buffer Solution, Ph 8.4

203. Tris, 1.0m Buffer Solution, Ph 8.6

204. Tris, 1.0m Buffer Solution, Ph 8.8

205. Tris, 1.0m Buffer Solution, Ph 9.0

206. Bp-13394

207. Smr000059179

208. Tris(hydroxymethyl)aminomethane Acs Grade

209. Tris(hydroxymethyl)aminomethane, Ultrapure

210. 2-amino-2-[hydroxymethyl]-1,3-propandiol

211. Db-091324

212. Ds-014869

213. Methanamine, 1, 1,1-tris(hydroxymethyl)-

214. Tris Acidimetric, Nist(r) Srm(r) 723e

215. A0321

216. Cs-0201542

217. Cs-0201543

218. Cs-0201544

219. Ft-0611014

220. Sw219208-1

221. T2516

222. Tris-buffered Saline (tbs, 10x) Ph 7.4

223. Tris-buffered Saline (tbs, 10x) Ph 7.6

224. Tris-buffered Saline (tbs, 10x) Ph 8.0

225. Tris-buffered Saline (tbs, 20x) Ph 7.4

226. 2-(hydroxymethyl)-2-amino-1, 3-propanediol

227. 2-amino-2-(hydroxyl-methyl)propane-1,3-diol

228. 2-amino-2-(hydroxymethyl) Propane-1,3-diol

229. 2-amino-2-(hydroxymethyl)-1,3-propanediol;

230. Tris-amino, Tromethane, Trometamol, Trisamine

231. Trizma(r) Base, Bioultra, >=99.8% (t)

232. Trizma(r) Base, Tested According To Ph.eur.

233. Tromethamine, Meets Usp Testing Specifications

234. C07182

235. D00396

236. M02623

237. P17498

238. Ab00443859_03

239. Ab00443859_04

240. Q413961

241. Sigma 7-9(r), >=99% (titration), Crystalline

242. Sr-01000944234

243. Trizma(r) Base, Puriss. P.a., >=99.7% (t)

244. J-610076

245. Sr-01000944234-1

246. Trizma(r) Base, >=99.9% (titration), Crystalline

247. Trizma(r) Base, Vetec(tm) Reagent Grade, >=99%

248. Trometamol(tris), Inverted Exclamation Marky99.5%

249. W-104296

250. Tris(hydroxymethyl)aminomethane, Acs Reagent, 99.9%

251. Tris-buffered Saline (tbs, 10x, Low Salt) Ph 8.0

252. F0001-1979

253. Tris(hydroxymethyl)aminomethane, Acs Reagent, >=99.8%

254. Tris(hydroxymethyl)aminomethane, Molecular Biology Grade

255. Tris-buffered Saline (tbs, 10x, High Salt) Ph 7.4

256. Z1317839150

257. Tris(hydroxymethyl)aminomethane, P.a., Acs Reagent, 99.8%

258. Tris(hydroxymethyl)aminomethane, Ultrapure Grade, >=99.9%

259. Tris-buffered Saline (tbs, 10x), With 1% Triton X-100

260. Trizma(r) Base, Puriss. P.a., Buffer Substance, >=99.5%

261. Trometamol, European Pharmacopoeia (ep) Reference Standard

262. Tris(hydroxymethyl)aminomethane, Jis Special Grade, >=99.0%

263. Tris, 1.0m Buffer Solution, Ph 7.0, 0.2 Micron Filtered

264. Tris, 1.0m Buffer Solution, Ph 8.5, 0.2 Micron Filtered

265. Tris, 1.0m Buffer Solution, Ph 9.0, 0.2 Micron Filtered

266. Tris-buffered Saline (tbs, 10x) Ph 7.4, For Western Blot

267. Trizma(r) Base, Anhydrous, Free-flowing, Redi-dri(tm), >=99.9%

268. Trizma(r) Base, Bioultra, For Molecular Biology, >=99.8% (t)

269. Tromethamine, United States Pharmacopeia (usp) Reference Standard

270. Trizma(r) Base, Cell Culture Tested, >=99.9% (titration), Crystalline

271. Trizma(r) Base, Bioxtra, Ph 10.5-12.0 (1 M In H2o), >=99.9% (titration)

272. Trizma(r) Base, Primary Standard And Buffer, >=99.9% (titration), Crystalline

273. Tromethamine, Pharmaceutical Secondary Standard; Certified Reference Material

274. 79261-03-3

275. Trizma(r) Base, Bioperformance Certified, Meets Ep, Usp Testing Specifications, Cell Culture Tested, >=99.9% (titration)

276. Trizma(r) Base, Certified Reference Material For Titrimetry, Certified By Bam, According To Iso 17025, >=99.5%

277. Tromethamine, Pharmagrade, Manufactured Under Appropriate Controls For Use As A Raw Material In Pharma Or Biopharmaceutical Production, Suitable For Cell Culture, Meets Usp, Ep, Jpc, Bp Testing Specifications.

278. Tromethamine, Pharmagrade, Manufactured Under Appropriate Controls For Use As A Raw Material In Pharma Or Biopharmaceutical Production., Suitable For Cell Culture, Meets Usp Testing Specifications

2.4 Create Date

2005-03-26

3 Chemical and Physical Properties

Molecular Formula	C₄H₁₁NO₃
Molecular Weight	121.14 g/mol
XLogP3	-2.9
Hydrogen Bond Donor Count	4
Hydrogen Bond Acceptor Count	4
Rotatable Bond Count	3
Exact Mass	121.07389321 g/mol
Monoisotopic Mass	121.07389321 g/mol
Topological Polar Surface Area	86.7 Å²
Heavy Atom Count	8
Formal Charge	0
Complexity	54
Isotope Atom Count	0
Defined Atom Stereocenter Count	0
Undefined Atom Stereocenter Count	0
Defined Bond Stereocenter Count	0
Undefined Bond Stereocenter Count	0
Covalently Bonded Unit Count	1

4 Drug and Medication Information

4.1 Drug Information

1 of 2
Drug Name	Tham
PubMed Health	Tromethamine (Injection)
Drug Classes	Acid-Base Disorder Agent
Drug Label	Tham Solution (tromethamine injection) is a sterile, non-pyrogenic 0.3 M solution of tromethamine, adjusted to a pH of approximately 8.6 with glacial acetic acid. It is administered by intravenous injection, by addition to ACD blood for priming cardi...
Active Ingredient	Tromethamine
Dosage Form	Injectable
Route	Injection
Strength	3.6gm/100ml
Market Status	Prescription
Company	Hospira

2 of 2
Drug Name	Tham
PubMed Health	Tromethamine (Injection)
Drug Classes	Acid-Base Disorder Agent
Drug Label	Tham Solution (tromethamine injection) is a sterile, non-pyrogenic 0.3 M solution of tromethamine, adjusted to a pH of approximately 8.6 with glacial acetic acid. It is administered by intravenous injection, by addition to ACD blood for priming cardi...
Active Ingredient	Tromethamine
Dosage Form	Injectable
Route	Injection
Strength	3.6gm/100ml
Market Status	Prescription
Company	Hospira

4.2 Therapeutic Uses

Buffers; Excipients

National Library of Medicine's Medical Subject Headings online file (MeSH, 1999)

/Tromethamine is indicated/ for the prevention and correction of metabolic acidosis. /Included in US product label/

Novak, K.M. (ed.). Drug Facts and Comparisons 59th Edition 2005. Wolters Kluwer Health. St. Louis, Missouri 2005., p. 130

Metabolic Acidosis Associated with Cardiac Bypass Surgery. Tromethamine solution has been found to be primarily beneficial in correcting metabolic acidosis which may occur during or immediately following cardiac bypass surgical procedures. /Included in US product label/

Medical Economics Co; Physicians Desk Reference: Generics 2nd ed p.3033 (1996)

Correction of Acidity of ACD Blood in Cardiac Bypass Surgery. It is well known that ACD blood is acidic and becomes more acidic on storage. Tromethamine effectively corrects this acidity. Tromethamine solution may be added directly to the blood used to prime the pump-oxygenator. When ACD blood is brought to a normal pH range the patient is spared an initial acid load. Additional tromethamine may be indicated during cardiac bypass surgery should metabolic acidosis appear. /Included in US product label/

Medical Economics Co; Physicians Desk Reference: Generics 2nd ed p.3033 (1996)

For more Therapeutic Uses (Complete) data for TROMETHAMINE (6 total), please visit the HSDB record page.

4.3 Drug Warning

Local reactions associated with administration of tromethamine may include local irritation and tissue inflammation or infection at the site of injection, a febrile response, chemical phlebitis, venospasm, hypervolemia, and iv thrombosis. The drug should be administered through a large needle or indwelling catheter to minimize venous irritation by the highly alkaline tromethamine solution. Extravasation may result in inflammation, necrosis, and sloughing of overlying skin. If perivascular infiltration occurs, tromethamine administration should be discontinued immediately. Infiltration of the affected area with 1% procaine hydrochloride, to which hyaluronidase has been added, will often reduce venospasm and also will dilute any tromethamine remaining in the tissues locally. Local infiltration of an alpha-adrenergic blocking agent, such as phentolamine mesylate, into the vasospastic area has been recommended. If necessary, nerve block of autonomic fibers to the affected area may be performed.

McEvoy, G.K. (ed.). American Hospital Formulary Service. AHFS Drug Information. American Society of Health-System Pharmacists, Bethesda, MD. 2007., p. 2647

Transient decreases in blood glucose concentration may occur during administration of tromethamine. When larger than recommended doses are used or when administration is too rapid, hypoglycemia may persist for several hours after the drug is discontinued.

McEvoy, G.K. (ed.). American Hospital Formulary Service. AHFS Drug Information. American Society of Health-System Pharmacists, Bethesda, MD. 2007., p. 2647

Tromethamine should be slowly administered and in amounts sufficient only to correct the existing acidosis, in order to avoid overdosage and alkalosis. Determinations of blood glucose concentrations should be frequently performed during and following therapy.

McEvoy, G.K. (ed.). American Hospital Formulary Service. AHFS Drug Information. American Society of Health-System Pharmacists, Bethesda, MD. 2007., p. 2647

Respiratory depression may occur in patients receiving large doses of tromethamine, as a result of increased blood pH and reduced carbon dioxide concentrations, and in those with chronic hypoventilation or those receiving other drugs that depress respiration. Dosage must be carefully adjusted so that blood pH does not increase above normal, and facilities for providing mechanical ventilation should be readily available during administration of tromethamine. Tromethamine may be used in conjunction with mechanical ventilatory support if respiratory acidosis is present concomitantly with metabolic acidosis.

McEvoy, G.K. (ed.). American Hospital Formulary Service. AHFS Drug Information. American Society of Health-System Pharmacists, Bethesda, MD. 2007., p. 2647

For more Drug Warnings (Complete) data for TROMETHAMINE (18 total), please visit the HSDB record page.

4.4 Minimum/Potential Fatal Human Dose

3. 3= MODERATELY TOXIC: PROBABLY ORAL LETHAL DOSE (HUMAN) 0.5-5 G/KG, BETWEEN 1 OZ & 1 PINT FOR 70 KG PERSON (150 LB).

Gosselin, R.E., H.C. Hodge, R.P. Smith, and M.N. Gleason. Clinical Toxicology of Commercial Products. 4th ed. Baltimore: Williams and Wilkins, 1976., p. II-74

4.5 Drug Indication

For the prevention and correction of metabolic acidosis.

FDA Label

5 Pharmacology and Biochemistry

5.1 MeSH Pharmacological Classification

Buffers

A chemical system that functions to control the levels of specific ions in solution. When the level of hydrogen ion in solution is controlled the system is called a pH buffer. (See all compounds classified as Buffers.)

Excipients

Usually inert substances added to a prescription in order to provide suitable consistency to the dosage form. These include binders, matrix, base or diluent in pills, tablets, creams, salves, etc. (See all compounds classified as Excipients.)

5.2 ATC Code

B - Blood and blood forming organs

B05 - Blood substitutes and perfusion solutions

B05B - I.v. solutions

B05BB - Solutions affecting the electrolyte balance

B05BB03 - Trometamol

B - Blood and blood forming organs

B05 - Blood substitutes and perfusion solutions

B05X - I.v. solution additives

B05XX - Other i.v. solution additives

B05XX02 - Trometamol

5.3 Absorption, Distribution and Excretion

Tromethamine is substantially eliminated by the kidneys. ... Ionized tromethamine (chiefly as the bicarbonate salt) is rapidly and preferentially excreted in urine at a rate that depends on the infusion rate. The manufacturer states that urinary excretion continues over a period of 3 days; 75% or more appears in the urine after 8 hours. In some studies, 50-75% of an iv dose was recovered in urine within 24 hours, but another study reported recovery in healthy adults to be 64% and 77% after 2 and 3 days, respectively.

McEvoy, G.K. (ed.). American Hospital Formulary Service. AHFS Drug Information. American Society of Health-System Pharmacists, Bethesda, MD. 2007., p. 2647

It is not known whether tromethamine is distributed in human milk.

McEvoy, G.K. (ed.). American Hospital Formulary Service. AHFS Drug Information. American Society of Health-System Pharmacists, Bethesda, MD. 2007., p. 2647

Ionized tromethamine is excreted by kidney, so the effect is that of excretion of hydrogen ions. Elimination of drug from body is entirely by renal excretion. Excretion of tromethamine is accompanied by osmotic diuresis, since clinical doses of drug considerably add to osmolarity of glomerular filtrate.

Osol, A. and J.E. Hoover, et al. (eds.). Remington's Pharmaceutical Sciences. 15th ed. Easton, Pennsylvania: Mack Publishing Co., 1975., p. 773

In rats of different age (5 to 240 days old) the renal excretion of Trishydroxymethylaminomethane (THAM) was studied. In 5 and in 240 days old rats the renal excretion of THAM was slower than in rats of other age groups. Stimulation of diuresis by i.p. injection of mannitol, thiazide or by oral water load resulted in an increase in THAM excretion in 5 and in 240 days old rats. The renal excretion of THAM was also increased by repeated administration of THAM in all age groups, except in new born rats. Possible mechanisms of action are discussed.

PMID:240333 Braunlich H; Arch Int Pharmacodyn Ther 216 (1): 144-59 (1975)

The distribution of 14C labelled THAM (tris-hydroxymethylaminomethane) was determined between intra- and extracellular space of nephrectomized Sprague-Dawley rats as a function of time at constant plasma pH of 7.4. The following results were obtained: An equilibrium in the distribution of THAM between ECS and ICS will not occur before 6-12 hours after administration. This indicates that THAM permeates very slowly into the intracellular compartment, which is in contrast to the general assumption that it quickly diffuses into the intracellular space to restore the intracellular acidosis. THAM disappears from the extracellular space in a multiexponential fashion, indicating that it equilibrates with the different body tissues at largely variable rates. The equilibrium which occurs between both body compartments 6-12 hours after THAM application does not agree with the values which are expected for transfer of only the nonionised substance. At plasma pH 7.4 and a "mean whole body pHi" of 6.88, THAM is distributed with a distribution ratio of 4 (ICS/ECS), a value quite different from the value of 11 which would be expected for exclusive nonionic diffusion. Thus THAM is also transferred across the cell membrane in ionized form. These results indicate that the influx of THAM into the intracellular space is too slow (when compared to the renal elimination kinetics) to influence intracellular pH significantly by direct buffer action. Moreover, only a fraction of THAM enters the intracellular space in the nonionized form, thus reducing (to an even greater extent) the direct effect of THAM on the intracellular acid-base equilibrium.

PMID:6711774 Rothe KF, Heisler N; Anasth Intensivther Notfallmed 19 (1): 24-6 (1984)

5.4 Metabolism/Metabolites

Tromethamine is not metabolized appreciably.

McEvoy, G.K. (ed.). American Hospital Formulary Service. AHFS Drug Information. American Society of Health-System Pharmacists, Bethesda, MD. 2007., p. 2647

5.5 Mechanism of Action

Tromethamine is an alkalinizing agent which acts as a proton (hydrogen ion) acceptor. Tromethamine is a weak base; following IV injection, it attracts and combines with hydrogen ions and their associated acid anions and the resulting salts are excreted in urine. Tromethamine can combine with lactic, pyruvic, and other metabolic acids and with carbonic acid. ... At pH 7.4, approximately 70% of the tromethamine present in plasma is in the ionized (protonated) form; if pH is decreased from pH 7.4, the ionized fraction of the drug is increased. In contrast to the ionized fraction of tromethamine, which upon administration reacts only with acid in the extracellular fluids, the fraction of the dose which remains un-ionized at physiologic pH is thought to be capable of penetrating the cell membrane to combine with intracellular acid. Since administration of tromethamine reduces hydrogen ion concentration, there is a decrease in proton donor and an increase in proton acceptor concentrations in body buffers. In the bicarbonate:carbonic acid buffer, the concentration of dissolved carbon dioxide is decreased (at least until regulatory mechanisms compensate) and the concentration of bicarbonate is increased. The reduction of carbon dioxide tension removes a potent stimulus to breathing and may result in hypoventilation and hypoxia.

McEvoy, G.K. (ed.). American Hospital Formulary Service. AHFS Drug Information. American Society of Health-System Pharmacists, Bethesda, MD. 2007., p. 2647

Tromethamine ... acts as a weak, osmotic diuretic, increasing the flow of alkaline urine containing increased amounts of electrolytes.

McEvoy, G.K. (ed.). American Hospital Formulary Service. AHFS Drug Information. American Society of Health-System Pharmacists, Bethesda, MD. 2007., p. 2647

By removing protons from hydronium ions, ionization of carbonic acid is shifted so as to decrease pCO2 and to increase bicarbonate. Excess bicarbonate is then gradually excreted in kidney. /Tromethamine is an/ especially useful way to manage excessively high pCO2 in respiratory acidosis...

Osol, A. and J.E. Hoover, et al. (eds.). Remington's Pharmaceutical Sciences. 15th ed. Easton, Pennsylvania: Mack Publishing Co., 1975., p. 773

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