THIOPENTONE SODIUM

Indications & Dose:

Anaesthesia of short duration, status epilepticus. Rapid control of convulsions. Infusion of subanaesthetic  doses can be used to facilitate verbal communication with psychiatric patients. Reduction of intracranial pressure.

Adults Inject i.v. (3-5mg/kg) as a 2.5% soln (25mg/ml) in fit premedicated (reduced elderly & debilitated) Children Induction 2-7 mg/kg 

Contraindications:

Airway obstruction. eg. epiglotitis oral or pharyngeal tumors, porphyria, hypersensitivity, hypotension, status asthmaticus, hepatic dysfunction, addison’s disease, myxoedema, acute intermittent porphyria and severe cardiovascular disease. 

Side Effects:

Hypotension, respiratory depression , tissue necrosis • Laryngeal spasm, bronchospasm, thrombophelebitis, allergic reactions, postoperative vertigo, euphoria, disorientation, true cutaneous allergy, photosensitivity, hiccups, apnoea for short period, nausea, vomiting. 

Cautions:

Precautions:

Special care is needed in the following circumstances. Cardiovascular system, hypovolaemia, myocardial disease, cardio vascular stenosis or constrictive pericarditis: myocardial depression may be severe in patients with a right to left intracardiac shunt, severe hepatic disease: a normal dose may be administered with great care and very slowly, renal disease: a normal dose may be administered but very slowly, muscle disease, respiratory depression is exaggerated in patients with anaesthesia grants & mysthenia gravis, reduced metabolic risk,  myxoedema. Obstetrics: an adequate dose is recommended excessive dose may cause respiratory and cardiac depression of fetus.

Out patient anaesthesia: Early recovery is slow, slow elimination may cause drowsiness for 24-36 hours —  potentiates the action of alcohol and sedative drugs, adrenocortical insufficiency, extremes of age, asthma,  avoid use in sitting position. No other drug can be mixed with thiopentone.

Pregnancy: Caution, use only when clearly indicated. Breast-feeding: Use with caution.Old age: May be given in reduced dose. 

Interaction:

Drugs

Narcotics: Dose of phenobarbitone required to induce anaesthesia reduced. Phenothiazines: Increased frequency and severity of neuromuscular excitation and hypotension.

Warnings:

Adverse Effects:

Lactations:

Special Precautions:

Counselling:

Side Effects Or Adverse Reactions:

CNS: Akathisia, altered temperature regula-tion, depression, dizziness, drowsiness, extrapyramidal reactions (dystonia, laryngospasm, motor restlessness, pseudoparkinsonism), headache, insomnia

CV: EGG changes, hypertension, hypotension, prolonged QT interval, torsades de pointes, ventricular tachycardia

EENT: Blurred vision, change in color per-ception, dry mouth, impaired night vision, mydriasis, photophobia

ENDO: Breast engorgement, galactorrhea

GI: Constipation, ileus, nausea

GU: Amenorrhea, decreased libido, ejacula-tion disorders, impotence, menstrual irregularities, priapism, urine retention

HEME: Agranulocytosis, anemia, aplastic anemia, eosinophilia, leukocytosis, leukope-nia, pancytopenia, thrombocytopenia

SKIN: Hyperpigmentation, jaundice, photosensitivity

Other: Weight gain

Patient And Carer Advice: