(thye-oh-pen'tal)
Pentothal
Classifications: central nervous system agent; general anesthetic; sedative-hypnotic; barbiturate
Pregnancy Category: C
Controlled Substance: Schedule III
| THIOPENTAL SODIUM (thye-oh-pen'tal) Pentothal Classifications: central nervous system agent; general anesthetic; sedative-hypnotic; barbiturate Pregnancy Category: C Controlled Substance: Schedule III |
20 mg/mL, 25 mg/mL injection
Ultrashort-acting barbiturate; induces brief general anesthesia without analgesia by depression of CNS. Loss of consciousness is rapid. Reduction in cardiac output and peripheral vasodilation frequently accompany anesthesia. Rapid redistribution of agent out of brain reduces anesthesia level and increases reflex airway hyperactivity to mechanical stimulation. Muscle relaxation is slight, and reflexes are poorly controlled.
Since analgesia is slight, thiopental is seldom used alone except for brief minor procedures. It does not act as an analgesic when given as an analgesic.
To induce hypnosis and anesthesia prior to or as supplement to other anesthetic agents or as sole agent for brief (15-min) operative procedures. Also used as an anticonvulsant and sedative-hypnotic and for narcoanalysis and narcosynthesis in psychiatric disorders.
Hypersensitivity to barbiturates; history of paradoxic excitation; absence of suitable veins for IV administration; status asthmaticus; acute intermittent or other hepatic porphyrias. Safety during pregnancy (category C), lactation, or children is not established.
Coronary artery disease, hypotension, shock; conditions that may potentiate or prolong hypnotic effect including excessive premedication, liver or kidney dysfunction, myxedema, Addison's disease, severe anemia, increased BUN; increased intracranial pressure; myasthenia gravis; asthma and other respiratory diseases.
| Induction Adult: IV Test Dose 25–75 mg, then 50–75 mg at 20–40 sec intervals, an additional 50 mg may be given if needed Child: IV 3–5 mg/kg initially, followed by 1 mg/kg if needed Infant: IV 5–8 mg/kg Neonate: IV 3–4 mg/kg Convulsions Adult: IV 75–125 mg Child: IV 2–3 mg/kg Narcoanalysis Adult: IV 100 mg/min until confusion occurs |
Note: Verify correct IV concentration and rate of infusion to neonates, infants, children with physician.
| Intravenous Test dose: May be given to assess unusual sensitivity to drug. Following administration, observe patient for at least 1 min for unexpected deep anesthesia or respiratory depression. PREPARE: Direct: Reconstitute each 500 mg of powder by adding at least 20 mL of sterile water for injection to yield a 2.5% solution (25 mg/1 mL). Add 20 mL of reconstituted solution to at least 100 mL of NS or D5W. Prepare solution freshly and use promptly. If a precipitate is present, discard solution. Unused portions should be discarded within 24 h. ADMINISTER: Direct: Infuse each 25 mg over 1 min or more. Do not infuse solution with a concentration <2.5% (concentration <2% causes hemolysis). INCOMPATIBILITIES Solution/additive: Dextrose Ringer's lactate, 10% dextrose, amikacin, benzquinamide, cephapirin, chlorpromazine, codeine phosphate, dimenhydrinate, diphenhydramine, doxapram, ephedrine, fibrinolysin, glycopyrrolate, hydromorphone, insulin, levorphanol, meperidine, metaraminol, methadone, morphine, norepinephrine, penicillin G, prochlorperazine, promazine, promethazine, sodium bicarbonate, succinylcholine, tetracycline. Y-site: Alfentanil, ascorbic acid, atracurium, atropine, cisatracurium, diltiazem, dobutamine, dopamine, ephedrine, epinephrine, furosemide, hydromorphone, labetalol, lidocaine, lorazepam, midazolam, morphine, nicardipine, norepinephrine, pancuronium, phenylephrine, succinylcholine, sufentanil, vecuronium.
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1%)Thiopental may cause decrease in I123 and I131 thyroidal uptake test results.
Assessment & Drug Effects
Patient & Family Education
Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; 
Canadian drug name; Prototype drug