Uses of Thiopen: - Anesthesia Status epilepticus, Induction of anesthesia, Reduction of raised intracranial pressure Thiopen for Injection is contraindicated in patients with severe respiratory embarrassment, hypersensitivity to barbiturates, status asthmaticus, variegate or acute intermittent porphyria, and inflammatory conditions of the mouth, jaw, and neck and in the absence of suitable veins for intravenous administration. Thiopental Sodium for Injection is also relatively contraindicated in severe cardiovascular disease, hypotension or shock, and conditions in which the hypnotic effect may be prolonged or potentiated, i.e. excessive premedication, Addison's disease, hepatic or renal dysfunction, myxedema, increased blood urea, severe anemia and myasthenia gravis.

General (Intravenous) anesthetics

Thiopental, a barbiturate, is used for the induction of anesthesia prior to the use of other general anesthetic agents and for induction of anesthesia for short surgical, diagnostic, or therapeutic procedures associated with minimal painful stimuli. Thiopental is an ultrashort-acting depressant of the central nervous system which induces hypnosis and anesthesia, but not analgesia. It produces hypnosis within 30 to 40 seconds of intravenous injection. Recovery after a small dose is rapid, with some somnolence and retrograde amnesia. Repeated intravenous doses lead to prolonged anesthesia because fatty tissues act as a reservoir; they accumulate Pentothal in concentrations 6 to 12 times greater than the plasma concentration, and then release the drug slowly to cause prolonged anesthesiaThiopental binds at a distinct binding site associated with a Cl- ionopore at the GABAA receptor, increasing the duration of time for which the Cl- ionopore is open. The post-synaptic inhibitory effect of GABA in the thalamus is, therefore, prolonged.

How to use Thiopental Sodium: Your doctor or nurse will give you this medicine. Kindly do not self administer. Adult Dose: Intravenous Induction of anaesthesia Adult: 100-150 mg of a 2.5 or 5% solution injected over 10-15 sec repeated every 30-60 sec according to response or as a continuous infusion of a 0.2 or 0.4% solution. Max: 500mg. Max in pregnancy: 250mg. Status epilepticus Adult: In conjunction with assisted ventilation: 75-125 mg as a 2.5% solution. Reduction of raised intracranial pressure Adult: Intermittent bolus inj of 1.5-3.5 mg/kg, if adequate ventilation is provided. Elderly: Dose reduction may be needed. Hepatic impairment: Dose reduction may be needed. Child Dose: Intravenous Induction of anaesthesia Child: 2-7 mg/kg over 10-15 seconds; repeated after 1 minute if needed.. Status epilepticus Child: 5 mg/kg by slow IV inj followed by, neonates: continuous iv infusion of 2.5 mg/kg/hr; >1 month: 2-8 mg/kg/hr. Adjust infusion dose according to response. Reduction of raised intracranial pressure Child: 3 mth-15 yr: initial 5-10-mg/kg IV followed by a continuous IV infusion at 1-4 mg/kg/hr. Renal Dose: Renal impairment: Dose reduction may be needed.

Possible increase in difficulty in producing anaesthesia in patients taking alcohol or CNS depressants. Additive action with other CNS depressants including sedatives, hypnotics, nitrous oxide or alcohol. Increased hypotension and excitatory effects with phenothiazine antipsychotics. Increased hypnotic effect with antipsychotic. Decreased requirement of thiopental sodium with metoclopramide, sulfisoxazole, aspirin, meprobamate, probenecid and other highly protein bound drugs. Potentially Fatal: Increased resp depression with opioids.

Thiopental Sodium for Injection is contraindicated in patients with severe respiratory embarrassment, hypersensitivity to barbiturates, status asthmaticus, variegate or acute intermittent porphyria, and inflammatory conditions of the mouth, jaw, and neck and in the absence of suitable veins for intravenous administration. Thiopental Sodium for Injection is also relatively contraindicated in severe cardiovascular disease, hypotension or shock, and conditions in which the hypnotic effect may be prolonged or potentiated, i.e. excessive premedication, Addison's disease, hepatic or renal dysfunction, myxedema, increased blood urea, severe anemia and myasthenia gravis.

Common - Injection site reactions (pain, swelling, redness) - Drowsiness - Skin rash - Nausea - Vomiting - Diarrhea - Vertigo Coughing, hiccupping, sneezing, muscle twitching, laryngospasm, bronchospasm. IV: tissue necrosis (if extravasation occurs). Intra-arterial: Severe arterial spasm with burning pain, blanching of forearm and hands and gangrene of digits. Potentially Fatal: Respiratory depression, arrhythmias, circulatory failure and anaphylactoid reactions.

Pregnancy Category C. Animal reproduction studies have not been conducted with Thiopental. It is also not known whether Thiopental can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Thiopental should be given to a pregnant woman only if clearly needed. Thiopental sodium readily crosses the placental barrier and small amounts may appear in the milk of nursing mothers following administration of large doses.

Precaution: Hypovolaemia; history of severe asthma, severe cardiac disease, severe anaemia, hyperkalaemia, toxaemia, myasthenia gravis, myxoedema; severe renal or hepatic disease; muscular dystrophies, adrenocortical insufficiency; increased intracranial pressure; elderly, pregnancy, lactation. Avoid extravasation or intra-arterial administration. IV inj of concentrated thiopental solution e.g. 5% may cause thrombophloebitis.

Overdosage may occur from too rapid or repeated administration. Too rapid injection may be followed by an alarming fall in blood pressure even to shock levels. Apnoea, occasional laryngospasm, coughing and other respiratory difficulties with excessive or too rapid injections may occur. In the event of suspected or apparent overdosage, the agent should be discontinued.

Store at controlled room temperature of 15° C to 30° C. Solutions should be freshly prepared and used immediately. Any portion of the contents remaining should be discarded.

General (Intravenous) anesthetics

Thiopental sodium, a short-acting barbiturate anaesthetic, is a CNS depressant inducing hypnosis and anaesthesia but not analgesia. It has also been used in the control of refractory tonic-clonic status epilepticus and to reduce increased intracranial pressure in neurosurgical patients.

Pregnancy Category C. Animal reproduction studies have not been conducted with Thiopental. It is also not known whether Thiopental can cause fetal harm when administered to a pregnant woman or can affect reproduction capacity. Thiopental should be given to a pregnant woman only if clearly needed. Thiopental sodium readily crosses the placental barrier and small amounts may appear in the milk of nursing mothers following administration of large doses.