Thiopental Sodium

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.