thiopental

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Generic Name: thiopental (THYE oh PEN tal)
Brand Names: Pentothal

What is thiopental?

Thiopental is in a group of drugs called barbiturates (bar-BIT-chur-ates). Thiopental slows the activity of your brain and nervous system.

Thiopental is used to help you relax before you receive general anesthesia with an inhaled medication.

Thiopental may be used for other purposes not listed in this medication guide.

What is the most important information I should know about thiopental? You should not receive this medication if you are allergic to thiopental or other barbiturates such as amobarbital (Amytal), butabarbital (Butisol), mephobarbital (Mebaral), secobarbital (Seconal), or phenobarbital (Solfoton).

You also should not receive thiopental if you have liver disease, Addison's disease, a severe thyroid disorder (myxedema), severe heart disease, severe low blood pressure, a severe breathing disorder, or a history of porphyria (an enzyme disorder that often causes blue discoloration of the skin).

Avoid drinking alcohol for at least 24 hours after you leave the hospital or surgery center. Thiopental can cause severe drowsiness or dizziness, which may last for several hours. You will need someone to drive you home after your surgery or procedure. Do not drive yourself or do anything that requires you to be awake and alert for at least 24 hours. What should I discuss with my health care provider before I receive thiopental? You should not receive this medication if you are allergic to thiopental or other barbiturates such as amobarbital (Amytal), butabarbital (Butisol), mephobarbital (Mebaral), secobarbital (Seconal), or phenobarbital (Solfoton), or if you have:

liver disease;

Addison's disease;

severe thyroid disorder (myxedema);

severe heart disease;

severe low blood pressure;

a severe breathing disorder; or

a history of porphyria (an enzyme disorder that often causes blue discoloration of the skin).

Tell your doctor if you have any of the conditions listed above.

FDA pregnancy category C. Thiopental may be harmful to an unborn baby. Tell your doctor if you are pregnant before you receive this medication. Thiopental can pass into breast milk and may harm a nursing baby. Before you receive this medication, tell your doctor if you are breast-feeding a baby. How is thiopental given?

Thiopental is given as an injection through a needle placed into a vein. You will receive this injection in a hospital or surgical setting.

You will be given this medication while you are lying down. You will fall asleep very quickly after thiopental is injected.

Your caregivers will monitor your heart function, blood pressure, and breathing while you are under the effects of thiopental.

What happens if I miss a dose?

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

What happens if I overdose?

An overdose of thiopental is unlikely to occur since the medication is given by a doctor. Your vital signs will be closely watched while you are under anesthesia to make sure the medication is not causing any harmful effects.

What should I avoid after receiving thiopental? Avoid drinking alcohol for at least 24 hours after you leave the hospital or surgery center. Thiopental can cause severe drowsiness or dizziness, which may last for several hours. You will need someone to drive you home after your surgery or procedure. Do not drive yourself or do anything that requires you to be awake and alert for at least 24 hours. Thiopental side effects 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 feel severe pain while receiving this medication.

Less serious side effects may include:

coughing;

sneezing; or

hiccups.

This is not a complete list of side effects and others may occur. Tell your doctor about any unusual or bothersome side effect. You may report side effects to FDA at 1-800-FDA-1088.

Thiopental Dosing Information

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.

What other drugs will affect thiopental?

Tell your doctor about all other medications you use, especially:

blood pressure medication; or

a diuretic (water pill).

This list is not complete and there may be other drugs that can interact with thiopental. Tell your doctor about all your prescription and over-the-counter medications, vitamins, minerals, herbal products, and drugs prescribed by other doctors. Do not start a new medication without telling your doctor.

More thiopental resources Thiopental Side Effects (in more detail) Thiopental Dosage Thiopental Use in Pregnancy & Breastfeeding Thiopental Drug Interactions Thiopental Support Group 1 Review for Thiopental - Add your own review/rating Thiopental MedFacts Consumer Leaflet (Wolters Kluwer) Pentothal Prescribing Information (FDA) Pentothal Monograph (AHFS DI) Compare thiopental with other medications Anesthesia Anesthetic Adjunct Coma Induction Head Injury Psychosis Seizures Where can I get more information? Your doctor or pharmacist can provide more information about thiopental.

See also: thiopental side effects (in more detail)

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