II. Dosing: Rapid Sequence Intubation

  1. Use lower dose if patient volume depleted
  2. Sedative Induction prior to intubation (RSI)
    1. Thiopental 3-5 mg/kg IVP

III. Pharmacokinetics

  1. Onset: 1 min
  2. Duration: 10-30 minutes
    1. May have prolonged duration with drug released from fat stores

IV. Indications: Sedation in Rapid Sequence Intubation (RSI)

  1. Largely replaced by newer agents for RSI (e.g. Etomidate, Ketamine)
  2. Situations where Thiopental might still be considered in RSI
    1. Status Epilepticus (Fast-acting anti-epileptic)
    2. Increased Intracranial Pressure (Fastest lowering of ICP of any induction agent)

V. Contraindication

VI. Adverse Effects

  1. Hypotension
  2. Histamine release
  3. Bronchoconstriction
  4. Skin necrosis if infiltrates (highly alkalotic agent with pH 10)

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