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Indications & Uses
TPS is indicated for:
Pharmacology
Thiopental is a barbiturate. Doctors use it to start anesthesia before giving other general anesthetic agents, and also to induce anesthesia for short surgical, diagnostic or therapeutic procedures that involve only minimal painful stimuli. It is an ultrashort-acting depressant of the central nervous system. It brings on hypnosis and anesthesia, but not analgesia. Hypnosis begins within 30 to 40 seconds of intravenous injection.
After a small dose, recovery is rapid, though there may be some somnolence and retrograde amnesia. Repeated intravenous doses are different, because they lead to prolonged anesthesia. Fatty tissues act as a reservoir and build up Pentothal in concentrations 6 to 12 times greater than the plasma concentration. They then release the drug slowly, and that is what prolongs the anesthesia.
Thiopental binds at a distinct binding site linked to a Cl- ionopore at the GABAA receptor, which increases the length of time the Cl- ionopore stays open. As a result, the post-synaptic inhibitory effect of GABA in the thalamus is prolonged.
Dosage Reference
Reference Information Only
Dosages shown are general references from official sources. Always consult your doctor or pharmacist for personalized dosing.
Adults:
Thiopental Sodium injection is given into a vein, normally as a 2.5% w/v solution. Sometimes a 5% w/v solution (500 mg in 10 ml) is used. The sterile powder is reconstituted with Water for Injections before use, usually to make a 2.5% w/v solution.
Premedication: This usually consists of atropine or scopolamine, which suppress vagal reflexes and inhibit secretions. A barbiturate or an opiate is often given as well. Ideally, these medicines should reach their peak effect shortly before induction.
Test dose: It's advisable to inject a small "test" dose of 25 mg to 75 mg first, to check for tolerance or unusual sensitivity to the medicine. Then pause and watch the patient's reaction for at least 60 seconds. If unexpectedly deep anesthesia develops or respiratory depression occurs, consider these possibilities: (1) the patient may be unusually sensitive to Thiopental Sodium, (2) the solution may be more concentrated than had been assumed, or (3) the patient may have received too much.
Use in anaesthesia: The normal dose for induction of anesthesia is 100 mg to 150 mg, injected over 10 to 15 seconds. If necessary, a repeat dose of 100 mg to 150 mg may be given after one minute. No fixed dose can be recommended for intravenous use, because the dose has to be adjusted carefully to the patient's response. Age, sex and weight of the patient should all be taken into account. Effective concentrations are reached in the brain within 30 seconds, and anesthesia is normally produced within one minute of an intravenous dose.
Adult: 100 mg to 150 mg intravenously over 10 to 15 seconds, normally as a 2.5% w/v solution. A repeat dose of 100 mg to 150 mg may be given after one minute. The injection should be given slowly, and the amount given should be titrated against the patient's response to minimize the risk of respiratory depression or overdose. The average dose for an adult of 70 kg is roughly 200 mg to 300 mg (8 ml to 12 ml of a 2.5% w/v solution), with a maximum of 500 mg.
Children: 2 mg/kg to 7 mg/kg bodyweight intravenously over 10 to 15 seconds, normally as a 2.5% w/v solution. A repeat dose of 2 mg/kg to 7 mg/kg may be given after one minute. The dose is 2 mg/kg to 7 mg/kg based on the patient's response. The dose for children should not exceed 7 mg/kg.
Elderly: Smaller adult doses are advisable.
Use in convulsive states: 75 mg to 125 mg (3 ml to 5 ml of a 2.5% w/v solution) should be given as soon as possible after the convulsion begins. Further doses may be needed to control a convulsion that follows the use of a local anesthetic. Other regimens, such as intravenous or rectal diazepam, may also be used to control convulsive states.
Side Effects
Hypersensitivity reactions have been reported with Thiopental Sodium. Other adverse reactions include respiratory depression, myocardial depression, cardiac arrhythmias, prolonged somnolence and recovery, hypotension, tachycardia, sneezing, coughing, bronchospasm, laryngospasm and shivering. Anaphylactic reactions have also been reported, and the symptoms can include urticaria, bronchospasm, vasodilation and edema.
Cautions & Contraindications
Warnings & Precautions
A person competent in anesthesia management should be with the patient at all times when Thiopental Sodium for injection is being used, and proper facilities to support breathing and circulation should be available. Only persons qualified in the use of anesthetics should give Thiopental Sodium. Use Thiopental Sodium with caution in patients who already have low blood pressure, or in conditions where the hypnotic effect may last longer or become stronger, such as liver disease and renal disease. Thiopental Sodium may be habit forming. Keep resuscitation and endotracheal intubation equipment and oxygen readily at hand, and keep the airway open at all times. Avoid extravasation and intra-arterial injection.
Contraindications
The absolute contraindications for Thiopental Sodium are the absence of suitable veins for intravenous administration, hypersensitivity (allergy) to barbiturates, variegate porphyria (South African) or acute intermittent porphyria, and status asthmaticus. The relative contraindications are severe cardiovascular disease, and hypotension or shock. They also include conditions in which the hypnotic effect may be prolonged or potentiated, for example excessive premedication, Addison's disease, hepatic or renal dysfunction, myxedema, increased blood urea, severe anemia, asthma and myasthenia gravis.
Pregnancy & Breastfeeding
Thiopental is listed as Pregnancy Category C. No animal reproduction studies have been done with it, so nobody knows whether it can harm the fetus when given to a pregnant woman, or whether it affects the ability to reproduce. For this reason, Thiopental should be given to a pregnant woman only if clearly needed. Thiopental sodium crosses the placental barrier easily. After large doses, small amounts may also appear in the milk of nursing mothers.
⚠️ Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
Overdose
Overdose of thiopental sodium can happen when it is given too fast or given repeatedly. If the injection is too rapid, blood pressure may fall alarmingly, even to shock levels. Too much or too quick an injection can also cause apnoea, and sometimes laryngospasm, coughing and other breathing difficulties. If an overdose is suspected or clearly present, stop giving the medicine.
⚠️ In an emergency call 999 or go to the nearest hospital emergency department.
Storage
Keep Thiopental Sodium at controlled room temperature, between 15° C and 30° C. Prepare the solution fresh and use it straight away. If any is left in the container afterwards, throw it away.
Drug Interactions
Common questions about TPS 500 mg
What is TPS 500 mg IV Injection?
TPS 500 mg IV Injection is a medicine that contains Thiopental Sodium. It is made by Popular Pharmaceuticals PLC. It belongs to the General (Intravenous) anesthetics group of medicines.
What is TPS used for?
TPS is used for: Pain, Local Anesthesia.
What are the side effects of TPS?
Hypersensitivity reactions have been reported with Thiopental Sodium. Other adverse reactions include respiratory depression, myocardial depression, cardiac arrhythmias, prolonged somnolence and recovery, hypotension, tachycardia, sneezing, coughing, bronchospasm, laryngospasm and shivering.
Can I take TPS during pregnancy or while breastfeeding?
Thiopental is listed as Pregnancy Category C. No animal reproduction studies have been done with it, so nobody knows whether it can harm the fetus when given to a pregnant woman, or whether it affects the ability to reproduce. Talk to your doctor before taking any medicine during pregnancy or while breastfeeding.
What happens if I take too much TPS?
Overdose of thiopental sodium can happen when it is given too fast or given repeatedly. If the injection is too rapid, blood pressure may fall alarmingly, even to shock levels. In an emergency call 999 or go to the nearest hospital emergency department.
How should I store TPS?
Keep Thiopental Sodium at controlled room temperature, between 15° C and 30° C. Prepare the solution fresh and use it straight away.
Can I take other medicines with TPS?
Some medicines can interact with Thiopental Sodium, for example: Aspirin, Nitrous Oxide, Metoclopramide. Tell your doctor or pharmacist about every medicine you take.
Do I need a prescription for TPS?
TPS is a prescription (Rx) medicine. Take it as your doctor advises.