Dangerous Drug: Pentobarbital, Pentobarbital Sodium(pen toe bar’ bi tal)
Nembutal
PREGNANCY CATEGORY D
CONTROLLED SUBSTANCE C-II
Drug Classes
Antiepileptic
Barbiturate
Sedative/hypnotic
Therapeutic Actions
General CNS depressant; barbiturates inhibit impulse conduction in the ascending RAS, depress the cerebral cortex, alter cerebellar function, depress motor output, and can produce excitation, sedation, hypnosis, anesthesia, and deep coma; at anesthetic doses, has antiseizure activity.
Indications
Sedative/hypnotic
Preanesthetic in pediatric patients
Antiepileptic, in anesthetic doses, for emergency control of certain acute seizure episodes (eg, status epilepticus, eclampsia, meningitis, tetanus, toxic reactions to strychnine or local anesthetics)
Contraindications and Cautions
Contraindicated with hypersensitivity to barbiturates or carbamazepine, manifest or latent porphyria, marked liver impairment, nephritis, severe respiratory distress, previous addiction to sedative-hypnotic drugs, pregnancy (fetal damage, neonatal withdrawal syndrome), lactation.
Use cautiously with acute or chronic pain (paradoxical excitement or masking of important symptoms), seizure disorders (abrupt discontinuation of daily doses can result in status epilepticus), fever, hyperthyroidism, diabetes mellitus, severe anemia, pulmonary or cardiac disease, status asthmaticus, shock, uremia, substance abuse, depression.
Available Forms
Injection—50 mg/mL
Dosages
Adults
Use only when prompt action is imperative.
IV: Give by slow IV injection, not to exceed 50 mg/min. Initial dose is 100 mg in a 70-kg adult. Wait at least 1 min for full effect. Base dosage on response. Additional small increments may be given up to a total of 200–500 mg. Minimize dosage in seizure states to avoid compounding the depression that may follow seizures.
IM: Inject deeply into a muscle mass. Usual adult dose is 150–200 mg. Do not exceed a volume of 5 mL at any site due to tissue irritation.
Pediatric patients
Use caution; barbiturates may produce irritability, aggression, inappropriate tearfulness.
IV: Reduce initial adult dosage on basis of age, weight, and patient’s condition: 1–6 mg/kg IV titrated in 1- to 2-mg/kg increments every 3–5 min.
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