Presentation
A patient who sustained thiopental extravasation and received local injection of lidocaine and local application of EMLA (Eutectic Mixture of Local Anesthetics) for treatment with excellent results is presented hereunder. [ncbi.nlm.nih.gov]
Entire Body System
- Weakness
No adverse events such as muscle weakness or patient discomfort were observed or reported by the patient. Time from injection of the intubating does of rocuronium to recovery of 25% of single twitch was 26 min. [ncbi.nlm.nih.gov]
Withdrawl symptoms : Abrupt withdrawal from barbiturates may cause tremors, anxiety, weakness, restlessness, nausea and vomiting, seizures, delirium, and cardiac arrest. [doctoralerts.com]
Common side effects may include: ongoing drowsiness; weak or shallow breathing; slow heartbeats; chills or shivering; sneezing, coughing, tight feeling in your throat; or bronchospasm (wheezing, chest tightness, trouble breathing). [drugs.com]
Injection ₹20/ml of Injection save 62% ₹6.48/ml of Injection save 88% ₹19.04/ml of Injection save 64% ₹41.3/ml of Injection save 22% Expert Advice Take special care if you have heart disease, circulatory problems, anemia, increased pressure in brain, muscle weakness [1mg.com]
- Myxedema
Drugs & Medications Thiopental Sodium Syringe Conditions: myxedema Addison's Disease Hereditary Liver Metabolism Disorder Liver Metabolism Disorder - Variegate Porphyria severe anemia Myasthenia Gravis abnormally low blood pressure Severe Prolonged Asthma [webmd.com]
Coronary artery disease, hypotension, shock; conditions that may potentiate or prolong hypnotic effect including excessive premedication, liver or kidney dysfunction, myxedema, Addison's disease, severe anemia, increased BUN; increased intracranial pressure [robholland.com]
Relative Contraindications Severe cardiovascular disease, hypotension or shock, conditions in which the hypnotic effect may be prolonged or potentiated ó excessive premedication, Addisonís disease, hepatic or renal dysfunction, myxedema, increased blood [druglib.com]
Use with extreme caution in patients with respiratory, cardiac, circulatory, renal, or hepatic dysfunction; severe anemia; shock; myxedema; and status asthmaticus because drug may worsen these conditions. [glowm.com]
- Acute Intermittent Porphyria
Contraindications : Acute intermittent porphyria Liver and kidney disease Severe pulmonary insufficiency. e.g. emphysema· Obstructive sleep apnoea. For detailed query or in case of uncertainty, Always consult your doctor or pharmacist. [doctoralerts.com]
Contraindications Absolute Contraindications Absence of suitable veins for intravenous administration, hypersensitivity (allergy) to barbiturates and variegate porphyria (South African) or acute intermittent porphyria. [druglib.com]
Acute attacks of variegate or acute intermittent porphyria may be triggered in susceptible individuals. Drug interactions Other cerebral depressants may augment the action of thiopental. [apps.who.int]
CONTRAINDICATIONS Absolute Contraindications Absence of suitable veins for intravenous administration, hypersensitivity (allergy) to barbiturates and variegate porphyria (South African) or acute intermittent porphyria. [rxlist.com]
- Fever
Aspirin also reduces fever. Rectal aspirin is used to reduce pain, inflammation, and fever. Aspirin is also used to treat the symptoms of arthritis and rheumatic fever. doxycycline (Vibramycin) Doxycycline is a tetracycline antibiotic. [emedicinehealth.com]
Broad-spectrum antibiotics may be required in the presence of fever. The role of hematopoietic growth factors such as granulocyte colony-stimulating factor is not yet defined. [ncbi.nlm.nih.gov]
[…] wrist or fingers, difficulty pinching or grasping, muscle weakness in the arms, wrist drop, fatigue, dizziness, heart palpitations, pale skin, headache, confusion, yellowing of the skin or eyes (jaundice), enlargement of the spleen or liver, chills, fever [rxlist.com]
- Fatigue
[…] respiratory depression, laryngospasm, cough, sneezing, apnoea Not known Gastrointestinal disorders Nausea, vomiting Not known Skin and subcutaneous tissue disorders Skin reaction Not known General disorders and administration site conditions Malaise, fatigue [medicines.ie]
[…] pain, slowed breathing, dysfunction of the heart, irregular heartbeat, slowed heartbeat, numbness from the triceps down to the fingers, difficulty extending the wrist or fingers, difficulty pinching or grasping, muscle weakness in the arms, wrist drop, fatigue [rxlist.com]
Musculoskeletal
- Muscle Weakness
No adverse events such as muscle weakness or patient discomfort were observed or reported by the patient. Time from injection of the intubating does of rocuronium to recovery of 25% of single twitch was 26 min. [ncbi.nlm.nih.gov]
weakness or degeneration, thyroid problems, asthma, burns, shock. [1mg.com]
Muscles usually relax about 30 seconds after unconsciousness is attained, but this may be masked if a skeletal muscle relaxant is used. The tone of jaw muscles is a fairly reliable index. [rxlist.com]
Psychiatrical
- Hypnotic State
Many likened it to a hypnotic state, whereby the drug would trick the subject into radically altering their behaviour. [chemistryworld.com]
Neurologic
- Confusion
We found inconsistency and confusion surrounding brain stem testing in this patient group, raising the possibility of misdiagnosis of brain stem death. [ncbi.nlm.nih.gov]
Side effects : Thiopentone may cause following Side effects : Drowsiness, Impaired concentration, Mental and physical sluggishness, Mental confusion (& Traffic accidents), Impaired performance, Hangover, Nausea, Dizziness, Idiosyncrasy, excitement, Porphyria [doctoralerts.com]
Shortly after counting becomes confused but before actual sleep is produced, the injection is discontinued. Allow the patient to return to a semidrowsy state where conversation is coherent. [drugs.com]
Use thiopental with caution if you are an elderly patient, as you may be more sensitive to its effects, especially drowsiness, depression, or confusion. Tell your doctor if you are or planning to become pregnant or are breastfeeding. [1mg.com]
Treatment
Early diagnosis and treatment may bear a favorable outcome. [ncbi.nlm.nih.gov]
Epidemiology
CONCLUSION: Because this multicenter study has an epidemiological character, the prevalence of i.v. thiopental use in psychiatric emergency settings in Japan is considered to be 8.0%. [ncbi.nlm.nih.gov]
The epidemiology of major depressive disorder: Results from the National Comorbidity Survey Replication (NCS-R). JAMA 2003;289:3095-105. 2. Sadock BJ, Sadock VA, Ruiz P, Kaplan HI. Kaplan and Sadock's Comprehensive Textbook of Psychiatry. [annals.in]
Prevention
Attention should be focused on the patient's reactions, the feeling of an intense pain and withdrawal of the leg during injection so that timely therapeutic measures are undertaken and the sad episode is prevented. [ncbi.nlm.nih.gov]
Alendronate slows bone loss while increasing bone mass, which may prevent bone fractures. Alendronate is used to treat or prevent postmenopausal osteoporosis and steroid-induced osteoporosis. [emedicinehealth.com]