Pronunciation: thigh-oh-PEN-tahl SO-dee-uhm
- Powder for injection 2% (20 mg/mL)
- Powder for injection 2.5% (25 mg/mL)
Depresses CNS to produce hypnosis and anesthesia without analgesia.
Thiopental is 80% bound to plasma proteins. The partition coefficient is 580.
Thiopental is degraded in liver and to a smaller extent, kidney and brain. The concentrations in spinal fluid is slightly less than in plasma.
Thiopental is eliminated in urine and t ½ is 3 to 8 h.
Indications and Usage
Induction of anesthesia; supplementation of other anesthetic agents; IV anesthesia for short surgical procedures with minimal painful stimuli; induction of hypnotic state; control of convulsions and increased intracranial pressure (IV administration); induction of preanesthetic sedation or basal narcosis (PR administration).
Hypersensitivity to barbiturates; variegate or acute intermittent porphyria; absence of suitable veins for IV administration; status asthmaticus.Rectal administration
Patients undergoing rectal surgery; lesions of bowel.
Dosage and AdministrationTest Dose
IV 25 to 75 mg; observe for 60 sec.Anesthesia
IV 50 to 75 mg slowly every 20 to 40 sec until anesthesia is established then 25 to 50 mg as needed or continuous infusion of 0.2% or 0.4%.Children
IV 5 to 6 mg/kg then 1 mg/kg as needed.Infants
IV 5 to 8 mg/kg then 1 mg/kg as needed.Newborns
IV 3 to 4 mg/kg then 1 mg/kg as needed.Convulsive States
IV 75 to 125 mg; may need 125 to 250 mg over 10 min.Children
IV 2 to 3 mg/kg/dose; repeat as needed.Increased Intracranial Pressure
IV 1.5 to 3.5 mg/kg.Children
IV 1.5 to 5 mg/kg/dose; repeat as needed.Psychiatric Disorders
IV 100 mg/min slowly with patient counting backwards or as infusion of 50 mL/min of 0.2% solution.Preanesthetic Sedation
PR 1 g/34 kg (30 mg/kg).Basal Narcosis
PR 1 g/22.5 kg (44 mg/kg) (max, 3 to 4 g for adults weighing over 90 kg).Children over 3 mo
PR 25 mg/kg/dose; if not sedated within 15 to 20 min, may repeat with single dose of 15 mg/kg/dose (max, 1.15 g for children over 34 kg).Children under 3 mo
PR 15 mg/kg/dose; if not sedated within 15 to 20 min, may repeat with single dose of less than 7.5 mg/kg/dose.
Store at room temperature, protected from light.
May cause additive barbiturate effects and increase risk of apnea.Phenothiazines
May increase frequency and severity of neuromuscular excitation and hypotension.Probenecid
May extend barbiturate effects or effects may be achieved at lower doses.Sulfisoxazole
May enhance barbiturate effects.
Tubocurarine, succinylcholine, or other acid pH solutions.
Laboratory Test InteractionsLFTs
Drug may falsely elevate results.Serum potassium
Drug may falsely elevate results.
Myocardial depression; arrhythmias.
Delirium, headache; amnesia; seizures.
Abdominal pain; rectal irritation; diarrhea; cramping; rectal bleeding (rectal suspension).
Apnea; laryngospasm; bronchospasm; hiccoughs; sneezing; coughing.
Thrombophlebitis; pain at injection site; salivation; shivering.
Category C ; readily crosses placental barrier.
Excreted in breast milk.
At increased risk of prolonged or potentiated hypnotic effects. Dosage reduction is required when administered rectally.
Use drug with caution in patients with renal disease. Dosage reduction is required (75% of normal dose if CrCl is less than 10 mL/min).
Use drug with caution in patients with hepatic disease.
Special Risk Patients
Use drug with caution in patients with severe CV, respiratory, renal, hepatic, or endocrine disease, hypotension or shock, conditions in which hypnotic effects may be prolonged or potentiated, potential rectal surgery (rectal suspension), or presence of inflammatory, ulcerative, bleeding, or neoplastic lesions of lower bowel (rectal suspension).
May result in prolonged drug effect because of accumulation.
Respiratory depression, hypotension, shock, apnea, occasional laryngospasm, coughing, respiratory difficulties.
- Instruct patient to notify health care provider of any signs of hypersensitivity to barbiturates.
- Inform patient to avoid alcohol or other CNS depressants for 24 h.
- Advise patient that drug can continue to impair abilities for 24 h following administration and caution patient to avoid driving or performing other tasks requiring mental alertness.
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