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erfamily of ion channels includes the neuronal nicotinic acetylcholine receptor nachr the 5 ht3 receptor the glycine receptor and others surprisingly while gaba a receptor currents are increased by barbiturates and other general anesthetics ligand gated ion channels that are predominantly permeable for cationic ions are blocked by these compounds for example neuronal nachr are blocked by clinically relevant anesthetic concentrations of both sodium thiopental and pentobarbital 31 such findings implicate non gabaergic ligand gated ion channels e g the neuronal nachr in mediating some of the side effects of barbiturates 32 the gaba a receptor is an inhibitory channel that decreases neuronal activity and barbiturates enhance the inhibitory action of the gaba a receptor 33 controversies edit following a shortage that led a court to delay an execution in california a company spokesman for hospira the sole american manufacturer of the drug objected to the use of thiopental in lethal injection hospira manufactures this product because it improves or saves lives and the company markets it solely for use as indicated on the product labeling the drug is not indicated for capital punishment and hospira does not support its use in this procedure 34 on january 21 2011 the company announced that it would stop production of sodium thiopental from its plant in italy because it could not provide italian authorities with guarantees that exported doses would not be used in executions according to a company spokesperson italy was the only viable place where it could produce the drug leaving the us without a supplier 35 in october 2015 the us food and drug administration fda confiscated an overseas shipment of thiopental destined for the states of arizona and texas the fda said in a statement courts have concluded that sodium thiopental for the injection in humans is an unapproved drug and may not be imported into the country 36 metabolism edit thiopental rapidly and easily crosses the blood brain barrier as it is a lipophilic molecule as with all lipid soluble anaesthetic drugs the short duration of action of sodium thiopental is due almost entirely to its redistribution away from central circulation into muscle and fatty tissue due to its very high lipid water partition coefficient approximately 10 leading to sequestration in fatty tissue once redistributed the free fraction in the blood is metabolized in the liver by zero order kinetics sodium thiopental is mainly metabolized to pentobarbital 37 5 ethyl 5 1 methyl 3 hydroxybutyl 2 thiobarbituric acid and 5 ethyl 5 1 methyl 3 carboxypropyl 2 thiobarbituric acid 38 dosage edit the usual dose range for induction of anesthesia using thiopental is from 3 to 6 mg kg however there are many factors that can alter this premedication with sedatives such as benzodiazepines or clonidine will reduce requirements due to drug synergy as do specific disease states and other patient factors among patient factors are age sex and lean body mass 39 specific disease conditions that can alter the dose requirements of thiopentone and for that matter any other intravenous anaesthetic are hypovolemia burns azotemia liver failure hypoproteinemia etc 40 contraindications edit thiopental should be used with caution in cases of liver disease addison s disease myxedema severe heart disease severe hypotension a severe breathing disorder or a family history of porphyria 41 42 co administration of pentoxifylline and thiopental causes death by acute pulmonary edema in rats this pulmonary edema was not mediated by cardiac failure or by pulmonary hypertension but was due to increased pulmonary vascular permeability 43 history edit 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 waters 44 in an investigation of its properties which were short term anesthesia and surprisingly little analgesia 45 three months later 46 dr john s lundy started a clinical trial of thiopental at the mayo clinic at the request of abbott 47 abbott continued to make the drug until 2004 when it spun off its hospital products division as hospira thiopental is famously associated with a number of anesthetic deaths in victims of the attack on pearl harbor these deaths relatively soon after the drug s introduction were said to be due to excessive doses given to shocked trauma patients however evidence available through the freedom of information legislation 48 suggested that the story was exaggerated of the 344 wounded that were admitted to the tripler army hospital only 13 did not survive and it is unlikely that thiopentone overdose was responsible for more than a few of them references edit anvisa 31 march 2023 rdc nº 784 listas de substâncias entorpecentes psicotrópicas precursoras e outras sob controle especial collegiate board resolution no 784 lists of narcotic psychotropic precursor and other substances under special control in brazilian portuguese diário oficial da união published 4 april 2023 archived from the original on 3 august 2023 retrieved 16 august 2023 pentothal dailymed retrieved 15 september 2025 russo h brès j duboin mp roquefeuil b 1995 pharmacokinetics of thiopental after single and multiple intravenous doses in critical care patients european journal of clinical pharmacology 49 1 2 127 37 doi 10 1007 bf00192371 pmid 8751034 s2cid 24285007 1 2 morgan dj blackman gl paull jd wolf lj june 1981 pharmacokinetics and plasma binding of thiopental ii studies at cesarean section anesthesiology 54 6 474 80 doi 10 1097 00000542 198106000 00006 pmid 7235275 world health organization 2025 the selection and use of essential medicines 2025 who model list of essential medicines 24th list geneva world health organization hdl 10665 382243 death penalty opposition eu set to ban export of drug used in us executions spiegel online international retrieved 23 january 2014 bryson eo december 2014 the abuse of agents used to induce or maintain general anesthesia intravenous hypnotics and the halogenated hydrocarbons in kaye ad vadivelu n urman rd eds substance abuse inpatient and outpatient management for every clinician new york springer p 115 doi 10 1007 978 1 4939 1951 2_10 isbn 978 1 4939 1951 2 oclc 897466425 can a drug make you tell the truth bbc news 3 october 2013 retrieved 19 may 2024 orwig j truth serum drugs do exist here s how medicines like sodium pentothal and scopolamine can manipulate the brain business insider retrieved 19 may 2024 çakırtekin v yıldırım a bakan n çelebi n bozkurt ö april 2015 comparison of the effects of thiopental sodium and propofol on haemodynamics awareness and newborns during caesarean section under general anaesthesia turkish journal of anaesthesiology and reanimation 43 2 106 112 doi 10 5152 tjar 2014 75547 pmc 4917150 pmid 27366476 gleason ca juul se 12 august 2011 avery s diseases of the newborn elsevier health sciences p 169 isbn 978 1 4557 2714 8 archived from the original on 26 november 2022 retrieved 13 august 2016 shibata y yokooji t itamura r sagara y taogoshi t ogawa k et al december 2016 injury due to extravasation of thiopental and propofol risks effects of local cooling warming in rats biochemistry and biophysics reports 8 207 211 doi 10 1016 j bbrep 2016 09 005 pmc 5613958 pmid 28955958 takeko t trauma org critical care barbiturate coma trauma org archived from the original on 19 august 2016 retrieved 18 august 2016 abraham p rennert rc gabel bc sack ja karanjia n warnke p et al december 2017 icp management in patients suffering from traumatic brain injury a systematic review of randomized controlled trials acta neurochirurgica 159 12 2279 2287 doi 10 1007 s00701 017 3363 1 pmid 29058090 s2cid 3013248 roberts i sydenham e december 2012 barbiturates for acute traumatic brain injury the cochrane database of systematic reviews 2012 12 cd000033 doi 10 1002 14651858 cd000033 pub2 pmc 7061245 pmid 23235573 trickey d anesthetic management of head injured patients www amcresidents com archived from the original on 18 october 2020 retrieved 13 october 2020 1 2 royal dutch society for the advancement of pharmacy 1994 administration and compounding of euthanasic agents the hague archived from the original on 21 august 2008 retrieved 18 july 2008 ohio executes inmate with 1 drug lethal injection associated press december 2001 retrieved 8 december 2009 martinez e 8 december 2009 kenneth biros execution ohio man first to die under 1 drug thiopental sodium method cbs news sullivan j 10 september 2010 killer on death row 16 1 2 years is executed the seattle times drug sold in uk to be used for execution in georgia bbc co uk bbc news 24 january 2011 retrieved 18 august 2016 casciani d 29 november 2010 us lethal injection drug faces uk export restrictions bbc co uk bbc news retrieved 18 august 2016 controls on torture goods detailed guidance gov uk gov uk retrieved 18 august 2016 eu council regulation eu no 1352 2011 truth serum used on serial child killers sydney morning herald reuters 12 january 2007 bannon a stevens sd 2007 the howdunit book of poisons howdunit cincinnati writers digest books isbn 978 1 58297 456 9 pearlman t december 1980 behavioral desensitization of phobic anxiety using thiopental sodium the american journal of psychiatry 137 12 american psychiatric association 1580 2 doi 10 1176 ajp 137 12 1580 pmid 6108082 drugged future time 24 february 1958 archived from the original on 10 september 2023 retrieved 16 june 2019 snelders s 1998 the lsd therapy career of jan bastiaans m d newsletter of the multidisciplinary association for psychedelic studies 8 1 multidisciplinary association for psychedelic studies 18 20 zádor i 1998 lélekgyógyítás tengereken túl egy pszichiáter visszaemlékezései soul healing overseas the memoirs of a psychiatrist in hungarian budapest aduprint pp 74 188 isbn 963 85647 9 2 weber m motin l gaul s beker f fink rh adams dj january 2005 intravenous anaesthetics inhibit nicotinic acetylcholine receptor mediated currents and ca2 transients in rat intracardiac ganglion neurons british journal of pharmacology 144 1 98 107 doi 10 1038 sj bjp 0705942 pmc 1575970 pmid 15644873 franks np lieb wr november 1998 which molecular targets are most relevant to general anaesthesia toxicology letters 100 101 1 2 1 8 doi 10 1016 s0378 4274 98 00158 1 pmid 10049127 anesthesia and analgesia university of virginia school of medicine archived from the original on 18 may 2007 retrieved 5 august 2007 pilkington e 28 september 2010 us executions delayed by shortage of death penalty drug guardian retrieved 18 june 2022 welsh huggins a 21 january 2011 key death penalty drug discontinued by u s maker nbc news retrieved 18 june 2022 solomon d 27 october 2015 the fda confiscated a supply of execution drugs texas is thought to have imported illegally texas monthly retrieved 10 march 2021 winters wd spector e wallach dp shideman fe july 1955 metabolism of thiopental s35 and thiopental 2 c14 by a rat liver mince and identification of pentobarbital as a major metabolite the journal of pharmacology and experimental therapeutics 114 3 343 57 pmid 13243246 dead link bory c chantin c boulieu r cotte j berthier jc fraisse d et al 1986 use of thiopental in man determination of this drug and its metabolites in plasma and urine by liquid phase chromatography and mass spectrometry comptes rendus de l académie des sciences série iii in french 303 1 7 12 pmid 3093002 avram m krejcie t henthorn t 1990 the relationship of age to the pharmacokinetics of early drug distribution the concurrent disposition of thiopental and indocyanine green anesthesiology 72 3 403 411 doi 10 1097 00000542 199003000 00002 pmid 2310019 pentothal rxlist webmd 15 november 2021 retrieved 18 june 2023 pentothal thiopental emedicinehealth 12 april 2009 archived from the original on 18 january 2015 retrieved 15 october 2010 james mf hift rj july 2000 porphyrias british journal of anaesthesia 85 1 143 53 doi 10 1093 bja 85 1 143 pmid 10928003 pereda j gómez cambronero l alberola a fabregat g cerdá m escobar j et al october 2006 co administration of pentoxifylline and thiopental causes death by acute pulmonary oedema in rats british journal of pharmacology 149 4 450 5 doi 10 1038 sj bjp 0706871 pmc 1978439 pmid 16953192 this month in anesthesia history march anesthesia history association archived from the original on 1 may 2011 steinhaus je september 2001 the investigator and his uncompromising scientific honesty asa newsletter 65 9 american society of anesthesiologists 7 9 archived from the original on 13 may 2011 lundy js april 1966 from this point in time some memories of my part in the history of anesthesia the journal of the american association of nurse anesthetists 34 2 american association of nurse anesthetists 95 102 pmid 5175948 archived from the original on 1 may 2011 thatcher vs 1984 1953 chapter 7 illegal or legal history of anesthesia with emphasis on the nurse specialist j b lippincott isbn 0 8240 6525 5 archived from the original pdf on 1 may 2011 bennetts fe september 1995 thiopentone anaesthesia at pearl harbor british journal of anaesthesia 75 3 366 8 doi 10 1093 bja 75 3 366 pmid 7547061 external links edit wikimedia commons has media related to sodium thiopental vassallo susi m d thiopental in lethal injection archive fordham urban law journal vol 35 issue 4 june 18 2008 pp 957 968 v t e general anesthetics n01a inhalational chloroform cyclopropane desflurane diethyl ether enflurane ethylene fluroxene halothane isoflurane methoxyflurane methoxypropane nitrous oxide sevoflurane trichloroethylene thiomethoxyflurane vinyl ether xenon injection phenols cipepofol ciprofol fospropofol propofol barbiturates amobarbital hexobarbital methohexital narcobarbital thiamylal thiopental thiotetrabarbital benzodiazepines midazolam diazepam lorazepam remimazolam opioids morphine oxycodone anileridine embutramide fentanyl alfentanil phenoperidine remifentanil sufentanil arylcyclohexylamines esketamine ketamine phencyclidine tiletamine neuroactive steroids alfadolone alfaxalone hydroxydione others etomidate propoxate metomidate propanidid who em withdrawn from market clinical trials phase iii never to phase iii v t e hypnotics sedatives n05c gaba a alcohols 2m2b chloralodol ethanol alcohol diethylpropanediol ethchlorvynol methylpentynol trichloroethanol barbiturates allobarbital amobarbital aprobarbital barbital butabarbital butobarbital cyclobarbital ethallobarbital heptabarb hexobarbital mephobarbital methohexital narcobarbital pentobarbital phenallymal phenobarbital propylbarbital proxibarbal reposal secobarbital talbutal thiamylal thiopental thiotetrabarbital vinbarbital vinylbital benzodiazepines brotizolam cinolazepam climazolam clobazam clonazolam doxefazepam estazolam flubromazolam flunitrazolam flunitrazepam flurazepam flutemazepam flutoprazepam loprazolam lormetazepam midazolam nimetazepam nitemazep...
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