Thiopental sodium


Concise Prescribing Info
Indications/Uses
Listed in Dosage.
Dosage/Direction for Use
Adult : IV Induction of anesth As 2.5 or 5% soln: 100-150 mg, repeat every 30-60 sec if needed. Max: 500 mg. Max in pregnant women: 250 mg. Status epilepticus W/ assisted ventilation: As 2.5% soln: 75-125 mg. Reduction of raised intracranial pressure Intermittent bolus inj of 1.5-3.5 mg/kg, if adequate ventilation is provided.
Dosage Details
Intravenous
Induction of anaesthesia
Adult: 100-150 mg of a 2.5 or 5% solution injected over 10-15 sec repeated every 30-60 sec according to response or as a continuous infusion of a 0.2 or 0.4% solution. Max: 500mg. Max in pregnancy: 250mg.
Child: 2-7 mg/kg over 10-15 seconds; repeated after 1 minute if needed..
Elderly: Dose reduction may be needed.

Intravenous
Reduction of raised intracranial pressure
Adult: Intermittent bolus inj of 1.5-3.5 mg/kg, if adequate ventilation is provided.
Child: 3 mth-15 yr: initial 5-10-mg/kg IV followed by a continuous IV infusion at 1-4 mg/kg/hr.
Elderly: Dose reduction may be needed.

Intravenous
Status epilepticus
Adult: In conjunction with assisted ventilation: 75-125 mg as a 2.5% solution.
Child: 5 mg/kg by slow IV inj followed by, neonates: continuous iv infusion of 2.5 mg/kg/hr; >1 month: 2-8 mg/kg/hr. Adjust infusion dose according to response.
Elderly: Dose reduction may be needed.
Renal Impairment
Dose reduction may be needed.
Hepatic Impairment
Dose reduction may be needed.
Incompatibility
Incompatible with acidic and oxidising substances, eg. amikacin sulfate, benzylpenicillin salts, cefapirin sodium, codeine phosphate, ephedrine sulfate, fentanyl citrate, glycopyrronium bromide, morphine sulfate, pentazocine lactate, prochlorperazine edisilate, suxamethonium salts and tubocurarine chloride. Do not use sterile water in IV infusion concentrations <2% since use of the resulting hypotonic solutions will cause haemolysis.
Contraindications
Porphyria; dyspnoea or respiratory obstruction.
Special Precautions
Hypovolaemia; history of severe asthma, severe cardiac disease, severe anaemia, hyperkalaemia, toxaemia, myasthenia gravis, myxoedema; severe renal or hepatic disease; muscular dystrophies, adrenocortical insufficiency; increased intracranial pressure; elderly, pregnancy, lactation. Avoid extravasation or intra-arterial administration. IV inj of concentrated thiopental solution e.g. 5% may cause thrombophloebitis.
Adverse Reactions
Coughing, hiccupping, sneezing, muscle twitching, laryngospasm, bronchospasm. IV: tissue necrosis (if extravasation occurs). Intra-arterial: Severe arterial spasm with burning pain, blanching of forearm and hands and gangrene of digits.
Potentially Fatal: Respiratory depression, arrhythmias, circulatory failure and anaphylactoid reactions.
IV/Parenteral: C
Overdosage
Acute lethal dose in human is unknown and variable. Lethal dose can be as low as 10 mcg/ml if co-admin with other CNS depressants or alcohol. Pulmonary (eg. apnea, laryngospasm, coughing), cardiovascular (eg. hypotension progressing to shock) and CNS effects. Discontinue drug and maintain patent airway, using assisted or controlled respiration and oxygen as necessary. Close monitoring of vital signs (eg. respiratory rate), fluid intake, blood gases and serum electrolytes. Laryngospasm may be relieved with a skeletal muscle relaxant, positive-pressure ventilation, endotracheal intubation or even tracheostomy.
Drug Interactions
Possible increase in difficulty in producing anaesthesia in patients taking alcohol or CNS depressants. Additive action with other CNS depressants including sedatives, hypnotics, nitrous oxide or alcohol. Increased hypotension and excitatory effects with phenothiazine antipsychotics. Increased hypnotic effect with antipsychotic. Decreased requirement of thiopental sodium with metoclopramide, sulfisoxazole, aspirin, meprobamate, probenecid and other highly protein bound drugs.
Potentially Fatal: Increased resp depression with opioids.
Food Interaction
Use of valerian, kava kava or St John's wort may prolong effect of thiopental. All herbal medicines should be stopped 2 wk prior to elective surgery.
Action
Description: Thiopental sodium, a short-acting barbiturate anaesthetic, is a CNS depressant inducing hypnosis and anaesthesia but not analgesia. It has also been used in the control of refractory tonic-clonic status epilepticus and to reduce increased intracranial pressure in neurosurgical patients.
Onset: IV: 30 sec. Rectal: 8-10 min.
Pharmacokinetics:
Distribution: Crosses the placenta and enters breast milk. Protein-binding: 80%
Metabolism: Hepatic; mostly converted to inactive metabolites.
Excretion: Elimination half-life: 10-12 hr (adults); 6 hr (childn); 26-28 hr (obese and pregnant patients).
Storage
Store at 20-25°C.
Disclaimer: This information is independently developed by MIMS based on Thiopental sodium from various references and is provided for your reference only. Therapeutic uses, prescribing information and product availability may vary between countries. Please refer to MIMS Product Monographs for specific and locally approved prescribing information. Although great effort has been made to ensure content accuracy, MIMS shall not be held responsible or liable for any claims or damages arising from the use or misuse of the information contained herein, its contents or omissions, or otherwise. Copyright © 2020 MIMS. All rights reserved. Powered by MIMS.com
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