Generic
Thiopental Sodium
13 brands available in the market
At a glance
Thiopental Sodium is an ultrashort-acting barbiturate general anesthetic used for induction of anesthesia, brief surgical procedures, and control of convulsive states.
Description
Thiopental Sodium is a barbiturate that binds to the Cl- ionophore at the GABAA receptor, increasing the duration of Cl- channel opening, prolonging GABA's postsynaptic inhibitory effect in the thalamus. It is an ultrashort-acting CNS depressant that induces hypnosis and anesthesia, but not analgesia.
Indications
- Induction of anesthesia (brief procedures)
- Induction prior to other anesthetics
- Supplement to regional anesthesia
- Control of convulsive states during inhalation anesthesia
- Reduction of increased intracranial pressure in neurosurgical patients
- Narcoanalysis and narcosynthesis in psychiatric disorders
Therapeutic class
General (Intravenous) Anesthetics
Pharmacological class
Ultrashort-acting Barbiturate
Pharmacology
Thiopental Sodium binds to the GABAA receptor, increasing Cl- ionophore opening duration, prolonging GABA's inhibitory effect in the thalamus. It produces hypnosis within 30-40 seconds of IV injection and may accumulate in fatty tissue for prolonged effects.
Mechanism of action
Depresses the CNS to induce anesthesia.
Dosage
Adult Dose (IV):
- Induction of anesthesia: 100-150 mg (2.5% solution) over 10-15 seconds; repeat 100-150 mg after 1 minute if needed; max 500 mg (250 mg in pregnancy)
- Convulsive states: 75-125 mg (2.5% solution)
- Increased intracranial pressure: 1.5-3.5 mg/kg intermittent bolus (with adequate ventilation)
Pediatric Dose (IV):
- Induction: 2-7 mg/kg over 10-15 seconds; repeat after 1 minute if needed (max 7 mg/kg)
- Convulsive states: 5 mg/kg slow IV; neonates: 2.5 mg/kg/hr IV infusion; >1 month: 2-8 mg/kg/hr
Administration
- IV administration only (usually 2.5% solution)
- Use test dose (25-75 mg) to assess tolerance
- Administered only by an anesthetist in a hospital
- Do not self-administer
Missed dose
Missed dose is not applicable (hospital use).
Side effects
Common Side Effects:
- Respiratory depression
- Myocardial depression, cardiac arrhythmias
- Prolonged somnolence and recovery
- Hypotension, tachycardia
- Sneezing, coughing, bronchospasm, laryngospasm
- Shivering, injection site reactions
Serious (Rare):
- Anaphylactic reactions (urticaria, bronchospasm, vasodilation, edema)
Precautions & warnings
- Do not use in severe respiratory embarrassment, status asthmaticus, porphyria
- Caution in severe cardiovascular disease, hypotension, shock
- Caution in hepatic/renal disease, myxedema, myasthenia gravis
- Habit-forming potential
Contraindications
- Hypersensitivity to barbiturates
- Status asthmaticus
- Variegate or acute intermittent porphyria
- Inflammatory conditions of the mouth, jaw, and neck
- Absence of suitable veins for IV administration
Drug interactions
- Alcohol and other CNS depressants: Additive CNS depression
- Phenothiazine antipsychotics: Increased hypotension and excitatory effects
- Opioids: Increased respiratory depression (potentially fatal)
- Metoclopramide, aspirin, probenecid: Decreased thiopental requirement
Food interactions
Alcohol is unsafe with Thiopental Sodium (increased CNS depression).
Use in pregnancy
Use in Pregnancy: May be unsafe; animal studies show harmful effects; use only if clearly needed; consult your doctor.
Pregnancy Category: D — always consult a doctor before taking during pregnancy.
Use in lactation
Use in Lactation: Safe during breastfeeding; human studies show insignificant passage into breast milk; consult your doctor.
Pediatric use
Indicated for children (with dose adjustment)
Geriatric use
Elderly: Use lower doses
Renal / hepatic impairment
Renal Impairment: Caution in kidney disease; dose adjustment may be needed; consult your doctor.
Hepatic Impairment: Caution in liver disease; dose adjustment may be needed; consult your doctor.
Overdose effects
Overdose from too rapid or repeated administration may cause severe hypotension, apnea, laryngospasm; discontinue drug and provide supportive treatment.
Storage conditions
Store at 15-30°C; prepare fresh solution and use immediately; discard unused portions; keep out of reach of children.
Chemical structure
Thiopental Sodium