Ultra-short action barbiturate general anesthesic.
PENTOVET is an ultrashort-acting barbiturate anesthetic. Slowly injected intravenously produces quick and quiet sleep, with a pleasant wake up within a few minutes, free from excitement, tremor and muscular hypertonia. PENTOVET may be used in a balanced anesthetic protocol in combination with local anesthetics, inhalation anesthesia, major and minor tranquilizers and muscle relaxants.
Pharmacokinetics: Due to its high lipid solubility, the thiobarbiturates quickly penetrate the central nervous system, resulting in deep hypnosis and anesthesia. After intravenous injection of a therapeutic dose, hypnosis and anesthesia occurs in approximately one minute. The drug rapidly crosses the blood brain barrier and from the central nervous system is redistributed to the muscle and body fat. Its short duration of action is mainly due to the redistribution in muscles and fatty deposits rather than to its rapid metabolism.
Once the concentrations of sodium thiopental in plasma, muscle and viscera descend, the drug concentrations in fat are held constant. On the other hand, an appreciable amount of the drug is rapidly metabolized by the liver, and this contributes to the rapid and early reduction of blood concentration of sodium thiopental. The same effect occurs after a fatty meal. A high level of chylomicrons in the blood produces a significant reduction in the time of anesthesia. Serum fat is more powerful than body fat deposits in terms of reducing anesthesia time is concerned.
Sodium thiopental is metabolized by microsomal enzymes in the liver and many metabolites have been isolated. The elimination half-life in dogs is estimated at approximately 7 hours and 3-4 hours in sheep. A small portion of the drug is excreted unchanged in urine, therefore dose adjustments are not necessary in patients with chronic renal failure.
DOSAGE:
Canine and Feline: 13.2 to 26.4 mg / kg intravenously slowly. This dose may be adjusted depending on the necessary duration of anesthesia. For 7-10 minutes of anesthesia: 15 to 17 mg / kg EV. For 10 to 15 minutes of anesthesia: 18-22 mg / kg EV. For 15-25 minutes of anesthesia: 22-29 mg / kg EV. In patients premedicated with tranquilizers (Acepromazine, Midazolam): 15.4 mg / kg EV. In patients premedicated with narcotic agonists / antagonists (nalbuphine) and agonists (fentanyl): 11 mg / kg EV.
Techniques of administration
• In non-premedicated dogs and cats: It should provide 50% of the total calculated dose bolus, 30 seconds after an assessment of the laryngeal reflex abolition. If the same is hereby supply the remaining 25% of the total dose calculated. If necessary and ultimately successive boluses of 25% of the total dose calculated at intervals of 30 seconds, leading to the abolition of the laryngeal reflex. • In patients sedated: We must follow the technique described for non-premedicated patients must take into account the above-described dose reduction (30% -80%).
HORSE SPORT: General Dose: 6.0 to 10 mg / kg. - Technical dump: Once the animal premedicated with acepromazine, midazolam and / or xylazine, we proceed to the slow intravenous infusion of a solution of guaiacol Glyceryl Ether 10% in dextrose 5%, to note the obvious presence of muscle relaxation in the hind. At this point interrupts the infusion of ether, to undertake a rapid bolus of 1.0 g of PENTOVET diluted in 10 mL of sterile distilled water for injection. After a deep yawn, the posture will be assisted by the animal, and then continue with the maintenance of anesthesia by slow drip, intravenous solution Glyceryl guaiacol ether alone or combined with intermittent doses of PENTOVET and / or Ketamine.
CATTLE: In animals over 150 kg, the recommended dose is 7.4 to 14 mg / kg, depending on the depth of anesthesia is required, should be administered quickly. To dose 10 mg / kg of PENTOVET, used in 25% solution will require 4.0 mL per 100 kg in weight.
CALVES: No more than 6 mg / kg will be required to achieve deep anesthesia.
SHEEP: For animals weighing approximately 17.5 kg, a dose of 9 to 13.5 mg / kg, depending on the desired depth of anesthesia.
SWINE: As in other species, there is an inverse relationship between dose level and weight of the animal. • 50-100 kg: 8 mg / kg. • 100-150 kg: 7 mg / kg. • 150-200 kg: 6 mg / kg.
The depth of anesthesia is determined by the loss of swallowing reflex, and corneal pedis. The first stage after the anesthetic drug administration often evidenced by a deep yawn followed by loss of reflexes above.
Although the initial dose is sufficient to perform the surgery, you must be prepared to administer additional drug if the patient requires.
ADMINISTRATION:
PENTOVET be administered intravenously only.
For your application to use syringe and needles.
Vial was taken from the volume of the reconstituted product to be supplied.
Product preparation: Reconstitution of Product: PENTOVET, is a sterile lyophilized powder, which should be reconstituted aseptically with the characteristics of all injectable products, with 20 or 40 mL of sterile water for injection or saline.
- Final concentration: reconstituted product 20 mL: 50 mg / mL and 40 mL: 25mg/mL. • Equine (dose dump): 100 mg / mL. - For your administration and Equine dump dose, 1.0 g PENTOVET be diluted in 10 mL of sterile water for injection or saline.
It will use a hypodermic needle and syringe and aseptic conditions appropriate to the management of injections, the syringe will be charged the amount and type of solvent used in the reconstitution of the product. After this procedure, it will break the seal on the vial containing the powder and punching the cap with the thinner needle is inserted into the dust. After this maneuver, withdraw the needle and syringe, whereafter the agitation of the reconstituted vial until translucent amber solution, free of precipitation. The dissolution of the powder is total. Waits a few minutes until you remove the possible foam formed by agitation, and the product and be able to be administered again used for application in the patient, syringe and hypodermic needle (sizes and volumes per species).
IV Injectable.
PRESENTATION:
Box containing 6 vials with 1.0 g each of thiopental sodium injection. Sterile lyophilized powder.
OBSERVATION:
PENTOVET is indicated as: - Inducing general anesthesia to facilitate intubation and to abolish the swallowing reflex prior to inhalation anesthesia maintenance. - As a single hypnotic agent in surgical or diagnostic procedures under 10 or 20 minutes in length (eg radiographs, myelography, endoscopies, tartar removal, reduction of fractures and clinical examinations). Animals can be completely anesthetized with a single intravenous dose.
- As long anesthetic in surgery, administering intermittent doses or continuous. Because ataxia period is short, the patient can leave the office without a prolonged rest. - As an anticonvulsant, becoming a first choice agent in patients with epilepsy. - As a hypnotic agent in patients with hydrocephalus, brain trauma, intracranial tumors or any other cause of acute or chronic intracranial hypertension.
Compatibility: - When in its dry form, the product is stable indefinitely. - Compatible with aminophylline, Chloramphenicol, Hyaluronidase, Hydrocortisone, neostigmine, Oxytocin, Pentobarbital, Phenobarbital, Potassium Chloride.
Incompatibilities: - Ringer solution and Ringer Lactate, Amikacin Sulfate, Atropine Sulfate, Sodium cephapirin, chlorpromazine, codeine, diphenhydramine, dimenhydrinate, ephedrine, glycopyrrolate, hydromorphone, insulin, meperidine, morphine sulfate, norepinephrine bitartrate, penicillin G potassium, promazine, succinylcholine, tetracycline hydrochloride. - Thiopental sodium can react with the plastic guides serum.
CONTRAINDICATIONS:
- Lack of suitable veins for intravenous administration. - Severe respiratory depression. - Hypersensitivity to the drug. - Abscesses and infections at the site of administration. - Pets asthmatics. - Do not use in neonates.
Relative contraindications: - In patients with: severe cardiovascular failure, ventricular arrhythmias, shock, myasthenia gravis, liver failure, anemia (hematocrit in dogs with less than 15 and less than 10 cats) and myxedema. - In horses, the sodium thiopental should not be used if there is pre-existing leucopenia. Some traders believe that the sodium thiopental should not be used alone in horses as it could cause episodes of ataxia and excitement. - Severe toxicity at Central Nervous System and tissue damage were observed in horses that received intra-carotid injections of sodium thiopental.
Precautions before use: - Is suggested not to reconstitute the product with solutions containing sodium bicarbonate. - While the stability studies of the reconstituted product indicate that it is stable for 3 days at room temperature and 7 days at 4 º C, it is suggested to reconstitute the product immediately before use, discarding all leftover after using the dose needed because that aqueous solutions of sodium thiopental are not chemically stable. - For the use of sodium thiopental should have the minimum equipment necessary to provide respiratory support (oxygen therapy, endotracheal tubes, breathing bag, Ambu bag, etc.).
- Because the placenta does not provide a protective barrier against the barbiturates, the total dose of anesthetic should not be used in pregnant females. Lower doses of this drug may be used as induction agents in these cases. - Check that the inviolability of the product system and storage conditions prior to use are adequate. - In no way and under no circumstances must uncover the product, transfer or expose their contents to the environment; maneuver that threaten the preservation of the right and the inviolability of the pack.
WARNINGS:
- Sodium thiopental has a very small effect on blood pressure, but if it acts at the respiratory center, can depress and slow breathing. - In patients with: liver or kidney damage, azotemia, hypovolemic patients, patients hypothermic. - Do not administer in conjunction with the respiratory depressant drugs. - Sodium thiopental concentrations less than 2% in water for injection produce hemolysis. - Produces perivascular injection phlebitis and / or tissue necrosis. - The joint administación catecholamines may potentiate the arrhythmogenic effect of thiopental sodium.
- All species and cats are particularly susceptible to transient apnea after drug administration may provide a slight pressure. - The dogs or their crosses may have a sleep time or hypnosis prolonged the supply of sodium thiopental. - The characteristics hypersalivation and bradycardia after administration of sodium thiopental, can be counteracted with the administration of anticholinergic agents (atropine and glycopyrrolate). - The repetition of successive doses of sodium thiopental, may prolong the recovery time of the patient.
Poisoning and overdose in animals: Treatment of iatrogenic barbiturate overdose, is maintaining the patient's breathing capacity (oxygen, ventilation), and the stabilization of the cardiovascular system (do not use catecholamines, eg epinephrine).
SUGGESTIONS:
- It is advisable to establish a solid and liquid fasting 12 hours prior to the administration of general anesthetics, may in summer, reduce the liquid fasting time to 6 hours. - It should be noted that in some species the fast has adverse effects. Some mammals, birds and neonatal hypoglycemia may manifest with a few hours of fasting, and the mobilization of glycogen stores may alter the parameters of the metabolism and clearance of drugs. The latter is an important factor in ruminants. - In contrast, food in dogs prior to induction, increases the metabolic rate by more than 18 hours.
- The induction of anesthesia in an animal that has a full stomach should be avoided, if possible, due to aspiration risks incurred. - Distention of the rumen in small and large ruminants impairs normal ventilation, with consequent hypoxia and hypercapnia. - Although food limitation does not empty the rumen, the possibility of regurgitation is reduced if done well liquid fast 12-24 hours prior to induction of anesthesia. - In the horse, the full stomach can rupture during induction, therefore, is recommended in solid and liquid fasting less than 6 hours. In very young animals and in patients older group, the water is usually offered until the last minute prior to the administration of preanesthetic agents.
- Remember that it is common for many elderly people suffer from canine nephritis, these patients must outweigh under normal conditions, and the stress of hospitalization, water deprivation and anesthesia, often without surgery, can cause acute decompensation. - The normal urine output can be restored by intravenous fluids administered continuously prior to the administration of anesthetic drugs. - In any case, it is good practice to administer anesthetic intravenous fluids during the same to help maintain adequate blood pressure and urine production, also having a permeable pathway for drug delivery.
- Systemic administration of broad spectrum antibiotics (eg ampicillin sodium IV) preparation is a useful prophylactic measure prior to major surgery or those in which imminent risk of contamination of the site to intervene. - It is recommended to proceed to empty the bladder immediately after induction with thiopental sodium. - Keep the product from 5 to 30 º C, away from direct sunlight, in dry and hygienic. - The warning suggested dose in all cases are at the discretion of the veterinarian is acting. - Exclusive sale prescription on file. - Recyclable container, destroy after use and throw waste collectors and not in the field or road. - Protect the environment. - Do not ingest. Keep out of reach of children. - Waste pathogenic.
