Thiopental

What is Thiopental

Thiopental is an intravenous ultra-short-acting barbiturate similar to methohexital.

Thiopental sodium is the sulfur analog of sodium pentobarbital. The onset of action and recovery are rapid, although thiopental has a longer duration of action than does methohexital.

Thiopental can be used alone as an anesthetic for short procedures, as an inducing agent, or as an adjunct to regional anesthesia.

It also has been used in narcoanalysis in psychiatric disorders, control of status epilepticus, and treatment of increased intracranial pressure.

Thiopental provides retrograde amnesia, which is often desired.

Thiopental was approved by the FDA in 1959.

Brand Name

Pentothal

Indications

1. general anesthesia induction
2. general anesthesia maintenance
3. head trauma
4. increased intracranial pressure
5. narcoanalysis
6. sedation induction
7. status epilepticus

Side Effects

1. amnesia
2. anaphylactoid reactions
3. anxiety
4. apnea
5. arrhythmia exacerbation
6. bronchospasm
7. confusion
8. cough
9. delirium
10. dizziness
11. drowsiness
12. edema
13. fatigue
14. headache
15. hemolysis
16. hiccups
17. hypotension
18. injection site reaction
19. malaise
20. nausea
21. phlebitis
22. psychomotor impairment
23. respiratory depression
24. seizures
25. shivering
26. tissue necrosis
27. tremor
28. vomiting

Monitoring Parameters

• CBC

Contraindications

• adrenal insufficiency
• agranulocytosis
• anemia
• asthma
• barbiturate hypersensitivity
• breast-feeding
• carbamazepine hypersensitivity
• cardiac disease
• chronic obstructive pulmonary disease (COPD)
• coadministration with other CNS depressants
• driving or operating machinery
• ethanol ingestion
• ethanol intoxication
• exfoliative dermatitis
• extravasation
• geriatric
• heart failure
• hepatic disease
• hepatic encephalopathy
• hydantoin hypersensitivity
• hypotension
• infants
• intraarterial administration
• labor
• myasthenia gravis
• myxedema
• neonates
• neuromuscular disease
• obstetric delivery
• porphyria
• pregnancy
• premature neonates
• pulmonary disease
• renal failure
• renal impairment
• requires a specialized care setting
• requires an experienced clinician
• respiratory depression
• respiratory insufficiency
• shock
• sleep apnea
• status asthmaticus
• uremia

Interactions

• Abemaciclib
• Acetaminophen
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• Acetaminophen; Butalbital
• Acetaminophen; Butalbital; Caffeine
• Acetaminophen; Butalbital; Caffeine; Codeine
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• Acetaminophen; Caffeine; Dihydrocodeine
• Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
• Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
• Acetaminophen; Codeine
• Acetaminophen; Dextromethorphan
• Acetaminophen; Dextromethorphan; Doxylamine
• Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
• Acetaminophen; Dextromethorphan; Phenylephrine
• Acetaminophen; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Dichloralphenazone; Isometheptene
• Acetaminophen; Diphenhydramine
• Acetaminophen; Guaifenesin; Phenylephrine
• Acetaminophen; Hydrocodone
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