Adult Dosing
Anesthesia induction
- 50-100 mg IV (over 20-40 secs) x 1; Alt :3-5 mg/kg
Anesthesia maintenance
Increased intracranial pressure (ICP)
- 1.5-3.5 mg/kg IV x 1; repeat as needed
Convulsive states
Pediatric Dosing
Anesthesia induction
- 2-6 mg/kg IV x 1; infants may require upto 8 mg/kg
- MAX: 100 mg/dose
Anesthesia maintenance
Increased intracranial pressure (ICP)
Seizures
- 2-3 mg/kg IV PRN
- MAX: 250 mg/dose
[Outline]
Renal Dose Adjustment (Based on CrCl)
- < 10 mL/min: Reduce dose by 25 %
Hepatic Dose Adjustment
- Hepatic impairment: Reduce dose; amount not defined
- Should only be administered by persons qualified in the use of intravenous anesthetics, and intra-arterial injections should be avoided
- Resuscitative and endotracheal intubation equipment should be readily available; maintain patent airway
- Thiopental is a very short-acting barbiturate; rapidly induces hypnosis and anesthesia without analgesia
- Administer by slow IV over 20-40 secs; rapid administration may cause severe hypotension
- Allergic reactions and hypersensitivity have been reported
- Local extravasation can result in extensive necrosis and sloughing
- Patients need to be advised against driving, operating machinery and taking alcohol for 24 hours
Cautions: Use cautiously in
- Renal impairment
- Hepatic impairment
- Severe cardiovascular disease (extreme caution required)
- Hypotension (extreme caution required)
- Shock (extreme caution required)
- Ophthalmoplegia
- Myasthenia gravis
- Endocrine insufficiency (pituitary, thyroid, adrenal, pancreas)
- Asthma
- Elderly patients
Pregnancy Category:C
Breastfeeding: Limited data indicates low levels in breast milk; breast-feeding should be temporarily suspended but can be resumed after recovery from general anesthesia. This information is based upon LactMed database (available at http://toxnet.nlm.nih.gov/cgi-bin/sis/htmlgen?LACT last accessed 29 July 2010).This drug is compatible and considered safe with breastfeeding based upon data from AAP Policy Guidelines (available at http://aappolicy.aappublications.org/cgi/content/full/pediatrics;108/3/776).
