Thiopental sodium

Acute asthma, respiratory obstruction, severe respiratory disease, inability to maintain an adequate airway during procedure; severe shock, constrictive pericarditis, porphyria, myotonic dystrophy, complete absence of suitable veins, inflammatory conditions of mouth, jaw, and neck.

Patient with other respiratory diseases, asthma, severe anaemia, burns, cachexia, CV disease, hypertension, endocrine insufficiency (e.g. Addison's disease, thyrotoxicosis, myxoedema, diabetes), haemodynamic instability (e.g. hypotension, hypovolaemia, dehydration, severe haemorrhage, shock), hyperkalaemia, toxaemia, myasthenia gravis; history of habituation or addiction to alcohol or drug abuse; increased intracranial pressure or blood urea. Debilitated and excessively premedicated patients. Patients taking metoclopramide, droperidol. Renal and hepatic impairment. Children and elderly. Pregnancy and lactation. Patient Counselling This drug may cause prolonged vertigo, disorientation or sedation, if affected, do not drive or operate machinery. Monitoring Parameters Monitor heart rate, respiratory rate and blood pressure. A test dose to evaluate patient's tolerance or unusual sensitivity to thiopental sodium is recommended.

Significant: CNS depression, extravasation (e.g. venospasm, irritation, extensive necrosis, sloughing), hypotension, respiratory depression, reduction in cardiac output; risk in precipitating acute circulatory failure (in patients with CV disease, particularly constrictive pericarditis); severe or refractory hypokalaemia (when used for raised intracranial pressure); risk for haemolysis (concentrations <2%). Cardiac disorders: Arrhythmia, myocardial depression. Gastrointestinal disorders: Hiccups. General disorders and administration site conditions: Shivering. Nervous system disorders: Somnolence, delayed wakening. Respiratory, thoracic and mediastinal disorders: Bronchospasm, laryngospasm, coughing, snoring.

Concurrent use with metoclopramide, droperidol, sulfonamides (e.g. sulfisoxazole) may enhance the therapeutic effect of thiopental sodium. May produce synergistic effects on CNS with other CNS depressants (e.g. those used for premedication). May potentiate hypotensive effect, CNS excitatory effects and sedative effects with antipsychotics (e.g. phenothiazine). May potentiate respiratory depressant effect and decrease antinociceptive effect with opioid analgesics. May reduce the analgesic effect of pethidine. May enhance toxicity with ketamine. Diminished therapeutic effect with aminophylline. Potentiated anaesthetic effect with midazolam, probenecid, aspirin. May enhance CNS depressant effect with Mg sulfate. May enhance the hypotensive effect of diazoxide, diuretics, nitrates, antihypertensives (e.g. methyldopa, moxonidine, hydralazine, minoxidil, Ca antagonists, ACE inhibitors, α and β-blockers), adrenergic neurone blockers. May diminish the therapeutic efficacy of estrogen.

Anaesthetics- local & general