Thiopental

Products

Thiopental is commercially available as an injectable (generic). It has been approved in many countries since 1947.

Structure and properties

Thiopental (C11H18N2O2S, Mr = 242.3 g/mol) is present in the drug as thiopental sodium, a yellowish white, hygroscopic powder that is readily soluble in water. It is a lipophilic thiobarbiturate identical to pentobarbital except for the sulfur atom.

Effects

Thiopental (ATC N01AF03) has sleep-inducing, depressant, and narcotic properties. The effects occur rapidly, within about 30 seconds, and last for about half an hour after a single dose. Thiopental has depressant effects on cardiac, circulatory, and respiratory function and should not be injected too rapidly. The effects are due to enhancement of the effects of the neurotransmitter GABA.

Indications

  • As an anesthetic for short procedures of less than 15 minutes.
  • For induction of anesthesia prior to the use of other anesthetics
  • As a supplement during regional anesthesia
  • As a sleep aid during combination anesthesia with analgesics and muscle relaxants
  • To control convulsive states during or after inhalation or local anesthesia or due to other causes

Off-label use

The drug is not intended or approved for these uses:

  • As a “lethal injection” (lethal injection) for executions (e.g., USA) in combination with other substances.
  • As truth serum
  • For physician-assisted euthanasia for the induction of coma prior to the administration of a neuromuscular blocker.

Dosage

According to the SmPC. The drug is administered parenterally (intravenously). Peroral administration is uncommon.

Contraindications

Full details of precautions and interactions can be found in the drug label.

Adverse effects

Possible adverse effects include:

  • Euphoric mood
  • Drowsiness, confusion, amnesia, unpleasant dream experiences.
  • Cardiac arrhythmias, low blood pressure, rapid pulse, vasodilatation, vascular occlusion.
  • Respiratory depression, respiratory disorders, laryngospasm.
  • Nausea, vomiting,
  • Hives, chills.
  • Reactions at the injection site
  • Hypersensitivity reactions up to anaphylaxis

Overdose is life-threatening and can lead to respiratory arrest, cardiovascular collapse and death.