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--- wikitox:thiamine [2018/09/01 09:01] – created - external edit 127.0.0.1
+++ wikitox:thiamine [2024/05/13 22:31] (current) – removed kharris
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-====== Thiamine ======
-Thiamine should be given routinely to all patients with alcohol intoxication, with a history of [[:wikitox:drug_and_alcohol_issues|alcohol abuse]] or physical examination findings suggesting liver disease or Wernicke's encephalopathy.
-Its routine use in patients with poisoning severe enough to require admission to an intensive care unit is probably justifiable given the difficulties in diagnosing encephalopathy in these patients.
-The dose is 100 mg IM daily for five days (or until the need for it can be reassessed).
-Oral thiamine may be poorly absorbed by patients with a history of alcohol abuse (particularly if they have a stomach full of [[:wikitox:3.2.2.2.3_activated_charcoal|charcoal]]).
-**Thiamine should always be administered prior to IV glucose.**
-===== REFERENCES =====
-[[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=7629986&dopt=Abstract|Hoffman RS, Goldfrank LR.]] The poisoned patient with altered consciousness. Controversies in the use of a 'coma cocktail'. JAMA 1995;274:562-569.\\
-[[http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=9039406&dopt=Abstract|Zubaran C, Fernandes JG, Rodnight R.]] Wernicke-Korsakoff syndrome. Postgraduate Medical Journal 1997; 73(855):27-31.