thiopentone
Table of Contents
thiopentone
see also:
introduction
- thiopentone is an ultra-short acting barbiturate primarily used as an induction agent to aid rapid sequence induction (RSI) for emergency intubation
- iv use only
- IM use causes pain/necrosis
- inadvertent intra-arterial injection of thiopentone → vasospasm
- consider alternatives if either:
- hypotensive
- head injury or acute stroke (secondary brain injury from transient hypotension is a risk)
- porphyria
- asthma - it can release histamine
preparation
- comes as a Pentothal 500mg/2.5% kit:
- reconstitute by adding the 20ml of supplied sterile water to the powder-containing bottle and dissolve
- use only if it is clear, free from precipitate and is not discolored
- solution is 25mg/ml (500mg per 20ml)
- use within 24 hours.
dosage
- iv induction dose: 3-5mg/kg
- reduce dose in elderly or those at risk of hypotension
pharmacology
- plasma:brain equilibration occurs within 1minute
- short acting due to redistribution (metabolised @ 12-16%/hr after single dose);
- large doses ⇒ myocard. depress.& decr. venous tone ⇒ decreased SV & cardiac output ⇒ hypotension
- potent resp. depressant
- decreased cerebral metabolism & cerebral blood flow (contrast with inhaled GAs!)
- may reduce hepatic & renal blood flow
thiopentone.txt · Last modified: 2009/03/18 05:36 by 127.0.0.1