Thiopentone / Thiopental / Penthiobarbital

• Anaesthesia

When should one not use Thiopentone / Thiopental / Penthiobarbital

• Allergy
• You should not use this drug if you have a known allergy to Thiopentone / Thiopental / Penthiobarbital Sodium or any other inactive ingredients in the formulation.
• Respiratory depression
• This medicine is not recommended for patients with respiratory depression due to the increased risk of the patient's condition worsening.
• Porphyria
• This medicine is not recommended for porphyria patients due to the higher risk of the patient's condition worsening.
• Myasthenia gravis
• This medicine is not recommended for people with myasthenia gravis since it increases the chance of the patient's condition worsening.
• Severe anaemia
• This medicine is not recommended for use in patients with severe anaemia due to the increased risk of the patient's condition worsening.

Common side effects of this drug are:

• Drowsiness
• Skin Rash
• Nausea
• Vomiting
• Diarrhoea
• Vertigo

Other General Warnings

• If you have heart disease- Due to worsening the patient's condition, this medicine should be used with caution in patients with heart disease. In some situations, dependent on the clinical condition of the patient, close monitoring, appropriate dose modifications, or replacement with a suitable alternative may be required.
• If you have thyroid disorders-Because of the danger of worsening the patient's condition, this medicine should be used with caution in patients with thyroid problems. In some situations, dependent on the clinical condition of the patient, close monitoring, appropriate dose modifications, or replacement with a suitable alternative may be required.
• If you have Hypovolemia-Due to the potential of worsening the patient's condition, this medicine should be used with caution in patients with a low level of fluids in the body. In some situations, dependent on the clinical condition of the patient, close monitoring, appropriate dose modifications, or replacement with a suitable alternative may be required.
• If you have hypotension-Patients receiving this medicine for anaesthesia should be continuously watched for evidence of severe hypotension (low blood pressure) or heart depression. Appropriate remedial actions, dose changes, or substitution with a suitable alternative may be required depending on the clinical situation.

How Does It Work?

Interactions with other medicines

• Gastrointestinal medicines like Metoclopramide and droperidol reduce the dose of Thiopentone / Thiopental / Penthiobarbital Sodium required to induce anaesthesia.
• Using anaesthetics with other CNS depressant medicines such as those used for premedication may produce synergistic effects on the CNS. In some cases, a smaller dose of general anaesthetic should be used.
• Benzodiazepines such as midazolam potentiate the anaesthetic effects of Thiopentone / Thiopental / Penthiobarbital Sodium.
• Pretreatment with probenecid has been shown to potentiate Thiopentone / Thiopental / Penthiobarbital Sodium anaesthesia.
• The enhanced hypotensive effects are seen when general anaesthetics are given with angiotensin-II receptor antagonists like Eprosartan, Irbesartan, Losartan, Olmesartan, Telmisartan.
• Hypersensitivity-like reactions can occur when general anaesthetics are given with intravenous vancomycin.
• Increased risk of arrhythmias and hypotension when general anaesthetics are given with tricyclic antidepressants. Hypotension and hypertension have been seen with MAOIs.
• The enhanced hypotensive effect may be seen when Thiopentone / Thiopental / Penthiobarbital Sodium is given with diazoxide.
• The enhanced hypotensive effect may be seen when Thiopentone / Thiopental / Penthiobarbital Sodium is given with diuretics.
• The enhanced hypotensive effect may be seen when Thiopentone / Thiopental / Penthiobarbital Sodium is given with methyldopa.
• Moxonidine: Enhanced hypotensive effect when Thiopentone / Thiopental / Penthiobarbital Sodium is given with moxonidine
• Nitrates: Enhanced hypotensive effect when given with nitrates.
• Vasodilator antihypertensives: Enhanced hypotensive effect when general anaesthetics given with hydralazine, minoxidil or nitroprusside.
• It should be noted that Thiopentone / Thiopental / Penthiobarbital Sodium will interact with beta-blockers and calcium antagonists, causing a fall in blood pressure.
• The enhanced hypotensive effect is seen with ACE inhibitors when Thiopentone / Thiopental / Penthiobarbital Sodium is given.
• Adrenergic neuron blockers: Enhanced hypotensive effect when Thiopentone / Thiopental / Penthiobarbital Sodium is given with adrenergic neurone blockers such as guanoxan, guanclofine and guanethidine.
• The enhanced hypotensive effect may be seen when Thiopentone / Thiopental / Penthiobarbital Sodium is given with alpha-blockers.
• Animal data suggest valerian and St John's Wort may prolong the effect of Thiopentone / Thiopental / Penthiobarbital Sodium.
• Pretreatment with aspirin has been shown to potentiate Thiopentone / Thiopental / Penthiobarbital Sodium anaesthesia.
• Opioids potentiate the respiratory depressive effect. The effect is enhanced by alcohol, hypnotics, centrally acting muscle relaxants, anxiolytics, antipsychotics and antihistamines.

Interactions with food items

• Thiopentone / Thiopental / Penthiobarbital's effects may persist longer than usual if you take St. John's wort. As a result, it should be avoided before any procedure that requires general anaesthesia or before any other usage of Thiopentone / Thiopental / Penthiobarbital.

Overdose

Missed a Dose