Thiopental sodium (When ATH N01AF03)
When ATH:
N01AF03
Characteristic.
Dry porous mass or yellowish powder (yellowish-greenish) color with a smell. Easily soluble in water. Aqueous solutions are alkaline reaction (pH approx. 10,0), not resistant (prepared immediately before use).
Pharmacological action.
Anesthesia, anticonvulsant, snotvornoe.
Application.
In / anesthesia during short surgical interventions, introductory and basic anesthesia during balanced anesthesia with the use of analgesics and muscle relaxants, large seizures (great evil), status epilepticus, increased intracranial pressure, prevention of cerebral hypoxia in traumatic brain injuries.
Contraindications.
Hypersensitivity, bronchial asthma, asthmatic status, liver and kidney dysfunction, violation of the contractile function of the myocardium, severe anemia, shock and condition kollaptoidnye, myasthenia, myxedema, Addison's disease, fever, inflammatory diseases of the nasopharynx, porphyria, pregnancy.
Side effects.
Arrhythmia, hypotension, depression or respiratory arrest, laringospazm, bronchospasm, nausea, vomiting; drowsiness, headache, chills, heart failure, irritation of the rectum and bleeding (in rectal route of administration), allergic reactions: hives, skin rash and itching, anaphylactic shock.
Cooperation.
It enhances the hypotensive effect, and hypothermic funds, It depresses the central nervous system under the influence of alcohol, sedatives, hypnotics, ketamine, neuroleptics, magnesium sulfate. Activity increases probenecid and H1-adrenoblokatorami; weakened — with aminophylline, analeptikami and some antidepressants.
Pharmaceutical incompatible (can not be mixed in the same syringe) with antibiotics (amikacin, benzilpenicillin, tsefapyryn), trankvilizatorami, miorelaksantami (suxamethonium, tuʙokurarin), analgesics (codeine), ephedrine, ascorbic acid, dipiridamolom, chlorpromazine and ketamine.
Overdose.
Symptoms: respiratory depression up to apnea, laringospazm, hypotension, tachycardia, cardiac arrest, pulmonary edema; postanesthesia delirium.
Treatment: bemegrid (specific antagonist). When you stop breathing-IVL, 100% oxygen; laringospazme-muscle relaxants and 100% pressurized oxygen; hypotonia-plazmozameŝaûŝie solutions, hypertensive drugs.
Dosing and Administration.
Adults for the induction of anesthesia: test dose is 25-75 mg, with the subsequent introduction of 50-100 mg at intervals of 30-40 c to achieve the desired effect, or once at the rate of 3-5 mg/kg. For maintenance of narcosis is 50-100 mg; mild seizures — 75-125 mg in/in, development of convulsing during local anesthesia 125-250 mg for 10 m. When cerebral hypoxia for 1 min is entered 1.5-3.5 mg/kg to temporary circulatory arrest; narkoanaliz — 100 mg for 1 m. In patients with impaired renal function (Cl creatinine less than 10 mL/min appointed 75% medium dose). The highest single dose for adults is 1 g.
Children: in/in struino, slowly (3-5 min) Once injected at the rate of 3-5 mg/kg. Before the inhalation narcosis without prior then the newborn is 3-4 mg/kg, from 1 to 12 month — 5-8 mg/kg, from 1 Year to 12 years — 5-6 mg/kg; anesthesia in children with a body weight of 30 to 50 kg-4-5 mg/kg. Supporting dose of 25-50 mg. In children with impaired renal function (Cl creatinine less than 10 mL/min is introduced 75% medium dose).
Precautions.
Introducing should be slowly (in order to avoid a sharp drop in blood pressure and the development of collapse). It is not recommended to use solutions with a concentration of less than 2% because of the risk of hemolysis.
