Thiopental, also sold under the brand name Pentothal, is a rapid-onset, short-acting anesthetic that’s used to prepare patients for surgery. Patients are given Pentathol intravenously before administering general anesthesia. Pentothal reduces anxiety.
Recreational use of Pentothal is rare due to limited access to the drug.
Pentothal’s side effects are like those of nearly all anesthetic medications. Pentothal depresses respiratory and cardiovascular function. Hypotension (low blood pressure) and airway obstruction may also occur.
Pentothal should only be administered by a trained medical professional in a sterile hospital environment.
Pentothal is a barbiturate that enhances the inhibitory action of the GABA receptor. GABA is a neurotransmitter in the brain that’s critical for reducing anxiety. GABA is the inhibitory neurotransmitter to the excitatory neurotransmitter glutamate. GABA reduces anxiety by decreasing glutamate activity.
Pentothal used to be the go-to medication for reducing anxiety before administering general anesthesia. A newer barbiturate, propofol, has since replaced Pentothal. Doctors may still choose to use Pentothal depending on local availability of certain drugs. Pentothal remains popular as an induction agent during intubation and in uses in obstetrics.
Following intravenous injection, Pentothal reaches the brain and can cause unconsciousness within 30-45 seconds. Peak concentrations of 60% are achieved in this time. After five to ten minutes, concentrations in the brain are low enough for consciousness to return.
Pentothal is not used for general anesthesia because it induces unconsciousness for too long when given at higher doses. This is due to the slow elimination rate of Pentothal. Inhaled anesthetics are eliminated more quickly and are preferred. It can take between 11.5 and 26 hours for Pentothal to be eliminated by the body.
Cases of Pentothal addiction have been reported but they are uncommon due to the restricted access to the drug.
Potential contraindications to Pentothal use include liver disease, myxedema, hypotension, severe breathing disorders, heart disease, Addison’s disease, or a family history of porphyria. Physicians who choose to administer pentoxifylline with Pentothal increase the patient’s risk of suffering acute pulmonary edema. In rodent studies, the combination of these medications has resulted in increased pulmonary vascular permeability.
When patients wake up following the use of Pentothal, they may have hangover-like symptoms that last for up to 36 hours. These side effects can include nausea, headache, extreme sleepiness and fatigue, and agitated emergence. Agitated emergence is a type of poor coordination that can linger after surgery.
Pentothal has some chemical similarities to sulfa drugs but does not trigger reactions in people who are allergic to sulfa. For some patients, the injection of Pentothal can trigger an immediate smell of rotting onions or garlic.
Some individuals experience other, less common side effects. Some patients have a hypersensitivity to Pentothal or have other pre-existing risk factors that can make symptoms worse. These additional side effects can include urticaria, bronchospasm, vasodilation, edema, coughing, respiratory depression, cardiac arrhythmias and myocardial depression. For patients with pre-existing conditions, Pentothal has, on rare occasions, induced immune hemolytic anemia with renal failure.
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