Thiopental sodium

Chemical name

5-Этилдигидро-5-(1-метил бутил)-2-тиоксо-4,6-(1Н,5H)- пиримидиндиона mononatrieva salt

Gross

C11-H17-N2-O2-S-Na

Characteristics

Dry porous mass or yellow powder (желтовато-зеленовато го) colour with a smell. Easily soluble in water. Aqueous solutions are alkaline reaction (pH of about 10.0), do not stand (prepared just before use).

Of drugs

The drugs-publeanestezirutee, protivosudorozhnoe, sleeping. Prolong the period of opening Gamczawisimah channels in postsinapticescoy neuronal membrane brain lengthens when his chlorine ions into nerve cells and causes giperpoliarizatia membranes. In high doses, is the Gamkmimeticescoe (directly activates Gamk_a-retseptora), suppresses the effects of amino acid stimuli (aspartata and glutamate). Threshold increases neuronal excitability and prevented and the convulsant momentum from the master brain (protivosudorojnaya activity). Suppress polisinapticalkie reflexes and slowing down on vstavocnam neironam spinal cord, thus miorelaxation. Impact metabolic processes in the brain, and the use of brain glucose and oxygen. Hypnotic effect is acceleration of the process of sleep, and changes in sleep. Oppressing breathing center and reduces its sensitivity to carbon dioxide. It cardiodepressiu. Reducyruet knock volume, heart and the release of AD increases capacity venous bed; Reduces liver bloodstream and speed clubockova Filtration.posle in / in the rapidly enters the brain and well krovosnabjaemye (skeletal muscle, kidney, liver) and jirovu (concentration in the fatty deposits above plasma in the 6-12 times) tissue. Linking blood plasma by 80-86%; Passes through the placental barrier, secretiruetsa in breast milk. T_1/2 Phase distribution 5-9 min. Treated biotransformation in the liver with the formation of active metabolites (small portion inaguiruetsa in the kidneys and brain). Eliminationny T_1/2 is 10-12 hrs, Excreted primarily in Pockami.posle / in the developing economies through 40 and under Rectal through 8-10 min; Narcosis of up to 15 minutes. In reintroduce the prolongiruetsa (koumouliruet).

Indications

B / anaesthesia in the short-term operational interventions, and the induction base anaesthesia with balanced anesthesia using analgesics and miorelaksantov large seizures (grand mal), a nervous, increased intracranial pressure, the prevention of brain hypoxia with head injuries.

Contraindications

Hypersensitivity, bronchial asthma, asthma status, liver function and kidney, the contractile function of heart, severe anaemia, and the shock of kollaptoidnye, male, miksedema, Addison disease, fever, inflammatory diseases chair, porphyria, and pregnancy.

Side-Effects

Adults and hypotension, oppression or stops breathing, laringospazm, bronhospazm, nausea, vomiting; Drowsiness, headache, vomiting, heart failure, irritation of the rectum and bleeding (with Rectal the way), allergic reactions : urticaria, skin and skin elasticity, anaphylactic shock.

Patient interaction

Do effect gipotenziveh and hypothermal means oppressing CNS under the influence of alcohol, sedatives, hypnotics, ketamina, Neuroleptics, magnesium sulfate. Activity increases and probenecidom H_1-adrenoblokatorami; Reduced-aminofillinom, analeptikami and some антидепрессантами.Фа��мацевтически compatible (it is not possible to confuse one sprite) with the antibiotic (amikacin, benzylpenicillin, sirapirin), tranquilizers, miorelaxanthami (suxamethonium, tubokurarin) analgetikami (codeine), ephedrine, ascorbic acid dipiridamolom, hlorpromazinom and ketaminom.

Overdosing

Symptoms : respiratory depression until ventricle, laringospazm, hypotension, tachycardia, cardiac arrest, swelling light; Postnarkozny Deliri.lechenie : bemegrid (specific antagonist). In the event of respiratory-cm, 100% oxygen; Laringospazme-muscle, and 100% oxygen under pressure; Hypotonia - plazmozameshchate solutions hypertensive drugs.

Precautions

Enter slowly (to avoid sharp fall AD and collapse). Is not recommended to use solutions with a concentration of less than 2% because of the risk of hemolysis.

Dosing and Administration

Adults to give anaesthesia : test-dose 75 mg, followed by 100 mg, with an interval of 30 to 40 seconds and achieve the desired effect, or one at 3-5 mg / kg To maintain narcosis is 50-100 mg; Convulsing mild-75-125 mg in / in the development convulsing during local anaesthesia Validity mg during 10 minutes. When brain hypoxia for 1 min introduces 1.5 mg / kg to temporarily stop blood; Narkoanalysis-100 mg for 1 min. In patients with functional kidney (Cl creatinine less than 10 ml / min assigned 75% of the average dose). The highest single dose for adults-1 G.detam in / in struino slowly (within 3-5 minutes) once imposed at the rate of 3-5 mg / kg Before the inhalation narcosis without prior Then the newborn 3-4 mg / kg, 1 to 12 months-5-8 mg / kg from 1 year to 12 years - 5-6 mg / kg; Narcosis for children weighing 30 to 50 kg-4-5 mg / kg Supporting dose of 25-50 mg. Children with disabilities kidney (Cl creatinine less than 10 ml / min being 75% of the average dose).

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