Home Drug Guide Thiopental Sodium

Drug Guide

Generic Name

Thiopental Sodium

Brand Names Pentothal

Classification

Therapeutic: Anesthetic, Sedative-Hypnotic

Pharmacological: Barbiturate

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

Assessment: Monitor cardiovascular and respiratory status closely during and after administration

Diagnoses:

  • Risk of decreased cardiac output
  • Risk of respiratory depression

Implementation: Ensure resuscitation equipment is available; administer slowly IV; monitor vital signs continuously

Evaluation: Observe for adequate anesthesia depth and recovery status

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

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.