Thiopentone

Thiopentone

[1 vial $12.55]

ADMINISTRATION ROUTES:

• IV, IM, PO

ALTERNATIVE NAMES:

• Thiopentone

ICU INDICATIONS:

1. Induction of anaesthesia
2. Treatment of status epilepticus refractory to other measures (rarely used for this indication)
3. Treatment of intracranial hypertension (rarely used for this indication in our ICU)

PRESENTATION AND ADMINISTRATION:

• IV: 500mg vials for reconstitution
  Reconstitute with Water for Injection
  For IV injection dilute 500mg to a total of 20ml using Water for Injection (makes a solution with a concentration of 25mg/ml)
  Store at room temperature

DOSAGE:

• IV: 2-5mg/kg slowly stat. In unstable patients (i.e. most ICU patients) administer 75mg at a time then assess effect on blood pressure and conscious state before administering more.

DOSAGE IN RENAL FAILURE AND RENAL REPLACEMENT THERAPY:

• Dose as in normal renal function

DOSAGE IN PAEDIATRICS:

• IV: 2-5mg/kg slowly stat

CLINICAL PHARMACOLOGY:

• Thiopental is an ultrashort-acting depressant of the central nervous system which induces hypnosis and anesthesia, but not analgesia. It produces hypnosis within 30-40 seconds of intravenous injection. Repeated intravenous doses lead to prolonged anesthesia because fatty tissues act as a reservoir; they accumulate thiopental in concentrations 6-12 times greater than the plasma concentration, and then release the drug slowly to cause prolonged anesthesia.

CONTRAINDICATIONS:

1. hypersensitivity to thiopentone
2. acute intermittent porphyria

WARNINGS

• Hypotension: Administer with caution in haemodynamically unstable patients

PRECAUTIONS

• General: Use with care in patients with reduced left ventricular function
• Laboratory Tests: No tests additional to routine ICU tests are required
• Drug/Laboratory Test Interactions: None known

IMPORTANT DRUG INTERACTIONS FOR THE ICU

• Thiopentone has a synergistic action with other CNS depressant drugs.

ADVERSE REACTIONS

• Body as a Whole: Anaphylactic and anaphylactoid reactions
• Cardiovascular: Hypotension, myocardial depression, arrhythmias
• Respiratory: Respiratory depression, coughing, bronchospasm and laryngospasm
• Skin: Urticaria.