High-dose sodium thiopental can have an active metabolite. Which metabolite is associated?

High-dose sodium thiopental can have an active metabolite. Which metabolite is associated?

• A. Active metabolite: pentobarbital
• B. No active metabolites
• C. Active metabolite: diazepam
• D. Active metabolite: morphine

Answer: (A)

High-dose sodium thiopental can be converted in the liver to an active metabolite, pentobarbital. After thiopental rapidly redistributes, hepatic metabolism forms pentobarbital, which remains pharmacologically active and can continue to depress the CNS, prolonging sedation and delaying emergence. This matters clinically because the metabolite’s longer action can contribute to prolonged effects after the parent drug levels have fallen, especially with high doses or hepatic impairment. Diazepam and morphine are not products of thiopental metabolism, and the idea of having no active metabolites does not fit the known metabolic pathway of thiopental.

High-dose sodium thiopental can be converted in the liver to an active metabolite, pentobarbital. After thiopental rapidly redistributes, hepatic metabolism forms pentobarbital, which remains pharmacologically active and can continue to depress the CNS, prolonging sedation and delaying emergence. This matters clinically because the metabolite’s longer action can contribute to prolonged effects after the parent drug levels have fallen, especially with high doses or hepatic impairment. Diazepam and morphine are not products of thiopental metabolism, and the idea of having no active metabolites does not fit the known metabolic pathway of thiopental.