Indication |
For use as the sole anesthetic agent for brief (15 minute)
procedures, for induction of anesthesia prior to administration of other
anesthetic agents, to supplement regional anesthesia, to provide
hypnosis during balanced anesthesia with other agents for analgesia or
muscle relaxation, for the control of convulsive states during or
following inhalation anesthesia or local anesthesia, in neurosurgical
patients with increased intracranial pressure, and for narcoanalysis and
narcosynthesis in psychiatric disorders. |
Pharmacodynamics |
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 anesthesia |
Mechanism of action |
Thiopental 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. |
Absorption |
Rapidly absorbed. |
Volume of distribution |
Not Available |
Protein binding |
Approximately 80% of the drug in the blood is bound to plasma protein. |
Metabolism |
Primarily hepatic. Biotransformation products of thiopental are pharmacologically inactive and mostly excreted in the urine. |
Route of elimination |
Not Available |
Half life |
3-8 hours |
Clearance |
Not Available |
Toxicity |
Overdosage may occur from too rapid or repeated injections. Too
rapid injection may be followed by an alarming fall in blood pressure
even to shock levels. Apnea, occasional laryngospasm, coughing and other
respiratory difficulties with excessive or too rapid injections may
occur. Lethal blood levels may be as low as 1 mg/100 mL for short-acting
barbiturates; less if other depressant drugs or alcohol are also
present. |