Natriumthiopental

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chemical structure of thiopental sodium
sodium thiopental

sodium 5-ethyl-6-oxo-5-pentan-2-yl-2-
sulfanyl-pyrimidin-4-olate
CAS number
71-73-8Vorlage:Ref 		ATC code
N01AF03
Chemical formula CVorlage:SubHVorlage:SubNVorlage:SubNaOVorlage:SubS
Molecular weight 264.321 g/mol
Bioavailability ?
Metabolism Hepatic
Elimination half-life 11.5Vorlage:Ref-26 hoursVorlage:Ref
Time to reach steady state ?
Excretion ?
Pregnancy category ?
Legal status Schedule III
Route(s) of administration Rectal, intravenous
Formulation(s) ?

Sodium thiopental also called Sodium Pentothal (a trademark of Abbott Laboratories), thiopental, thiopentone sodium, or trapanal is a rapid-onset, short-acting barbiturate general anesthetic.

Uses

It induces general anaesthesia within 60 seconds of intravenous injection and lasts around 10-30 minutes. Up until fairly recently it was the most popular anesthetic induction agent in many parts of the world. However, it has been overtaken by propofol, particularly for day surgery.

Thiopental has no analgesic effects so it is only used as a single agent for brief procedures. More commonly, it is used to induce anesthesia prior to the use of other anesthetic agents. It is also used to control intracranial pressure in head trauma patients, and has been reported to be more effective for this than pentobarbital.Vorlage:Ref and was used in narcotherapy.

Along with pancuronium bromide and potassium chloride thiopental is used in some States of the US as part of the lethal injection. In the Netherlands, it is used to cause death after the induction of a coma by barbiturates.

It is still used in some places as a truth serum, most recently in Pakistan for Abu Faraj al-Libbi.Vorlage:Ref

Metabolism

Sodium thiopental is mainly metabolized to pentobarbital,Vorlage:Ref 5-ethyl-5-(1'-methyl-3'-hydroxybutyl)-2-thiobarbituric acid, and 5-ethyl-5-(1'-methyl-3'-carboxypropyl)-2-thiobarbituric acid.Vorlage:Ref

Side Effects

As with nearly all anaesthetic drugs, thiopental causes cardiovascular and respiratory depression resulting in hypotension, apnea and airway obstruction. For these reasons, only anesthesiologists and other suitably trained doctors should give thiopental in an environment suitably equipped to deal with these effects. Side effects include headache, emergence delirium, prolonged somnolence and nausea. The hangover effects may last up to 36 hours.

History

Sodium thiopental was discovered in the early 1930s by Ernest H. Volwiler and Donalee L. Tabern, working for Abbott Laboratories. It was first used in human beings on March 8, 1934, by Dr. Ralph M. WatersVorlage:Ref in an investigation of its properties, which were short-term anesthesia and surprisingly little analgesia.Vorlage:Ref Three months later,Vorlage:Ref Dr. John S. Lundy started a clinical trial of thiopental at the Mayo Clinic at the request of Abbott.Vorlage:Ref

It is famously associated with a number of anaesthetic deaths in victims of the attack on Pearl Harbor. These deaths, relatively soon after its discovery, were due to excessive doses given to shocked trauma patients.

External links

References and End Notes

  1. Vorlage:Note THIOPENTAL SODIQUE Biam.
  2. Vorlage:Note Morgan DJ, Blackman GL, Paull JD, Wolf LJ. "Pharmacokinetics and plasma binding of thiopental. I: Studies in surgical patients." Anesthesiology. 1981 Jun;54(6):468-73. PMID 7235274
  3. Vorlage:Note Morgan DJ, Blackman GL, Paull JD, Wolf LJ. "Pharmacokinetics and plasma binding of thiopental. II: Studies at cesarean section." Anesthesiology. 1981 Jun;54(6):474-80. PMID 7235275
  4. Vorlage:Note Pérez-Bárcena J, Barceló B, Homar J, Abadal JM, Molina FJ, de la Peña A, Sahuquillo J, Ibáñez J. "Comparison of the effectiveness of pentobarbital and thiopental in patients with refractory intracranial hypertension. Preliminary report of 20 patients]" [Article in Spanish] Neurocirugia (Astur). 2005 Feb;16(1):5-12; discussion 12-3. PMID 15756405 Fulltext
  5. Vorlage:Note Massoud Ansari in Karachi Truth drug fails to get al-Qa'eda No 3 to talk
  6. Vorlage:Note WINTERS WD, SPECTOR E, WALLACH DP, SHIDEMAN FE. "Metabolism of thiopental-S35 and thiopental-2-C14 by a rat liver mince and identification of pentobarbital as a major metabolite." Journal of Pharmacology Experimental Therapeutics. 1955 Jul;114(3):343-57. PMID 13243246
  7. Vorlage:Note Bory C, Chantin C, Boulieu R, Cotte J, Berthier JC, Fraisse D, Bobenrieth MJ. "[Use of thiopental in man. Determination of this drug and its metabolites in plasma and urine by liquid phase chromatography and mass spectrometry]" [Article in French] C R Acad Sci III. 1986;303(1):7-12. PMID 3093002
  8. Vorlage:Note This Month in Anesthesia History: March
  9. Vorlage:Note Steinhaus, John E. The Investigator and His ‘Uncompromising Scientific Honesty’ American Society of Anesthesiologists. NEWSLETTER. September 2001, Volume 65, Number 9.
  10. Vorlage:Note Imagining in Time—From this point in time: Some memories of my part in the history of anesthesia -- John S. Lundy, MD August 1997, AANA Archives-Library
  11. Vorlage:Note History of Anesthesia with Emphasis on the Nurse Specialist Archives of the American Association of Nurse Anesthetists. 1953
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