II. Dosing: Rapid Sequence Intubation
- Use lower dose if patient volume depleted
-
Sedative Induction prior to intubation (RSI)
- Thiopental 3-5 mg/kg IVP
III. Pharmacokinetics
- Onset: 1 min
- Duration: 10-30 minutes
- May have prolonged duration with drug released from fat stores
IV. Indications: Sedation in Rapid Sequence Intubation (RSI)
- Largely replaced by newer agents for RSI (e.g. Etomidate, Ketamine)
- Situations where Thiopental might still be considered in RSI
- Status Epilepticus (Fast-acting anti-epileptic)
- Increased Intracranial Pressure (Fastest lowering of ICP of any induction agent)
V. Contraindication
- Hypotension
- Asthma
- Congestive Heart Failure
- Porphyria
VI. Adverse Effects
- Hypotension
- Histamine release
- Bronchoconstriction
- Skin necrosis if infiltrates (highly alkalotic agent with pH 10)