Generic Name

Thiopental Sodium

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Classification

FDA Approved Indications

• Induction of anesthesia for surgeries and procedures

Mechanism of Action

Thiopental Sodium enhances GABA-A receptor activity, increasing chloride ion influx, leading to hyperpolarization of neuronal membranes and depressant effects on the Central Nervous System, resulting in anesthesia.

Dosage and Administration

Adult: 2.5-5 mg/kg IV, titrated to desired effect

Pediatric: Not typically used in children due to safety concerns

Geriatric: Start at lower end of dosing range, monitor closely for respiratory and cardiovascular depression

Renal Impairment: Use with caution; dose adjustment may be necessary

Hepatic Impairment: Use cautiously; metabolism may be prolonged

Pharmacokinetics

Absorption: Administered IV, rapid onset

Distribution: Wide, crosses blood-brain barrier and placental barrier

Metabolism: Hepatic biotransformation

Excretion: Renal, primarily as metabolites

Half Life: Approximately 3-8 hours, but effects are brief due to redistribution

Contraindications

• Hypersensitivity to barbiturates
• Porphyria

Precautions

• Cardiovascular disease, respiratory impairment, history of drug dependence, pregnancy (category D), and caution in elderly

Adverse Reactions - Common

• Hypotension (Occasional)
• Respiratory depression (Common)
• Nausea and vomiting (Common)

Adverse Reactions - Serious

• Cardiac arrest (Rare)
• Cytopenias (Rare)
• Allergic reactions (Rare)

Drug-Drug Interactions

• Other CNS depressants, including alcohol, opioids, benzodiazepines

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Patient/Family Teaching

• Inform about possible respiratory and cardiovascular effects
• Advise not to operate machinery or drive for at least 24 hours after use
• Report any signs of allergic reactions or adverse effects

Special Considerations

Black Box Warnings:

• Potential for respiratory and cardiovascular depression, risk of overdose

Genetic Factors: Porphyria may be exacerbated

Lab Test Interference: May alter liver function tests temporarily

Overdose Management

Signs/Symptoms: Deep coma, respiratory depression, hypotension, hypothermia, cardiac arrest

Treatment: Supportive care, maintain airway and breathing, administer vasopressors if needed, activated charcoal if ingestion recent, consider hemoperfusion in severe cases

Storage and Handling

Storage: Store at room temperature, protected from light and moisture

Stability: Stable until expiration date when stored properly