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
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