Introduction
Pentothal Sodium is a prescription medicine used for producing general anesthesia. It is also used as truth serum because it alters certain functions in the brain and make the person incapable of lying. It has now been used to reduce intracranial pressure also.
Pentothal Sodium is given as an injection in hospital settings under the supervision of a healthcare professional. It is important to provide medical history and inform your doctor if you are suffering from cardiovascular disease, asthma or myasthenia gravis as special care is needed in administering this medicine to such patients.
Some common side effects of this medicine are skin rash or pain at the site of injection, nausea, vomiting, diarrhea, and vertigo. It may cause dizziness and sleepiness, so do not drive or do anything that requires mental focus. You should avoid drinking alcohol or taking other medications that cause drowsiness after taking this medicine as it may result in serious effects. Ensure that you practice additional pregnancy control methods as this medicine may decrease the effectiveness of birth control pills.
Side effects of Pentothal Sodium
Common
- Injection site reactions (pain, swelling, redness)
- Drowsiness
- Skin rash
- Nausea
- Vomiting
- Diarrhea
- Vertigo
How to use Pentothal Sodium
Your doctor or nurse will give you this medicine. Kindly do not self administer.
How Pentothal Sodium works
Pentothal Sodium is a general anaesthetic. It works by causing reversible loss of consciousness to allow surgery without pain and distress.
Indication
Status epilepticus, Induction of anesthesia, Reduction of raised intracranial pressure
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.
Contraindication
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.
Mode of Action
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.
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.
Side Effect
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.
Interaction
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.