Thiopental

This is not a complete list of Thiopentaldrug interactions. Ask your doctor or pharmacist for more information.

Thiopental is available in the following forms:

• Enema
• Enemas
• Injectable Solution
• Prefilled Syringe

Since thiopental is usually given just for anesthesia, you are not likely to be on a dosing schedule.

Usual Adult Dose for Anesthesia:

When used for induction in balanced anesthesia with a skeletal muscle relaxant and an inhalation agent:
The total dose can be estimated and then injected in two to four fractional doses. With this technique, brief periods of apnea may occur which may require assisted or controlled pulmonary ventilation. As an initial dose, 210 to 280 mg (3 to 4 mg/kg) is usually required for rapid induction in the average adult (70 kg).

When used as the sole anesthetic agent:
Moderately slow induction can usually be accomplished in the "average" adult by injection of 50 to 75 mg (2 to 3 mL of a 2.5% solution) at intervals of 20 to 40 seconds, depending on the reaction of the patient. Once anesthesia is established, additional injections of 25 to 50 mg can be given whenever the patient moves. The desired level of anesthesia can be maintained by injection of small repeated doses as needed or by using a continuous intravenous drip in a 0.2% or 0.4% concentration. With continuous drip, the depth of anesthesia is controlled by adjusting the rate of infusion.

Usual Adult Dose for Seizures:

For the control of convulsive states following anesthesia (inhalation or local) or other causes, 75 to 125 mg (3 to 5 mL of a 2.5% solution) should be given as soon as possible after the convulsion begins. Convulsions following the use of a local anesthetic may require 125 to 250 mg given over a ten minute period.

Usual Adult Dose for Coma Induction:

In neurosurgical patients, intermittent bolus injections of 1.5 to 3.5 mg/kg of body weight may be given to reduce intraoperative elevations of intracranial pressure, if adequate ventilation is provided.

Usual Adult Dose for Psychosis:

For narcoanalysis and narcosynthesis in psychiatric disorders, premedication with an anticholinergic agent may precede administration of thiopental. After a test dose, thiopental is injected at a slow rate of 100 mg/min (4 mL/min of a 2.5% solution) with the patient counting backwards from 100. Shortly after counting becomes confused but before actual sleep is produced, the injection is discontinued. Allow the patient to return to a semidrowsy state where conversation is coherent. Alternatively, thiopental may be administered by rapid IV drip using a 0.2% concentration in 5% dextrose and water. At this concentration, the rate of administration should not exceed 50 mL/min.

Usual Pediatric Dose for Anesthesia:

Induction anesthesia:
less than 1 month: 3 to 4 mg/kg intravenously
less than 1 year: 5 to 8 mg/kg intravenously
1 year to 12 years: 5 to 6 mg/kg intravenously
over 12 years: 3 to 5 mg/kg intravenously

Maintenance anesthesia:
1 year and older: 1 mg/kg intravenously as needed

Usual Pediatric Dose for Seizures:

1 year or older: 2 to 3 mg/kg/dose intravenously, repeat as needed.

Usual Pediatric Dose for Head Injury:

1 year or older: 1.5 to 5 mg/kg/dose intravenously; repeat as needed to control intracranial pressure - larger doses (30 mg/kg) to induce coma after hypoxic-ischemic injury do not appear to improve neurologic outcome.

Other drugs may interact with thiopental, including prescription and over-the-counter medicines, vitamins, and herbal products. Tell each of your health care providers about all medicines you use now and any medicine you start or stop using.

Applies to thiopental: intravenous powder for injection

Get emergency medical help if you have any of these signs of an allergic reaction while taking thiopental: hives; difficult breathing; swelling of your face, lips, tongue, or throat.

You will remain under constant supervision during treatment with thiopental. Your caregivers will watch for any serious side effects. Tell your caregivers at once if you have severe pain while receiving this medicine.

Common side effects may include:

• ongoing drowsiness;

• weak or shallow breathing;

• slow heartbeats;

• chills or shivering;

• sneezing, coughing, tight feeling in your throat; or

• bronchospasm (wheezing, chest tightness, trouble breathing).

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect.

Applies to thiopental: intravenous powder for injection, rectal suspension

Cardiovascular

Cardiovascular side effects have included myocardial depression, cardiac arrhythmias, and a fall in blood pressure even to shock levels.[Ref]

Respiratory

Respiratory side effects have included respiratory depression, sneezing, coughing, bronchospasm, and laryngospasm.[Ref]

Nervous system

Nervous system side effects have included prolonged somnolence and recovery. Radial nerve palsy has been reported rarely.[Ref]

Hypersensitivity

Hypersensitivity side effects have included anaphylactic and anaphylactoid reactions, e.g., urticaria, bronchospasm, vasodilation and edema.[Ref]

General

General side effects have included shivering.[Ref]

Hematologic

Hematologic side effects have included rare reports of immune hemolytic anemia with renal failure.[Ref]

Some side effects of thiopental may not be reported. Always consult your doctor or healthcare specialist for medical advice. You may also report side effects to the FDA.

1 year or older: 1.5 to 5 mg/kg/dose intravenously; repeat as needed to control intracranial pressure - larger doses (30 mg/kg) to induce coma after hypoxic-ischemic injury do not appear to improve neurologic outcome.

Data not available