Dangerous Drug: Phenobarbital



Dangerous Drug: Phenobarbital





(fee noe bar’ bi tal)


Phenobarbital

Oral preparations: Bellatal, Solfoton


Phenobarbital Sodium

Parenteral: Luminal Sodium, PMS-Phenobarbital (CAN)

PREGNANCY CATEGORY D

CONTROLLED SUBSTANCE C-IV


Drug Classes

Antiepileptic

Barbiturate (long-acting)

Hypnotic

Sedative


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 subhypnotic doses, has antiseizure activity, making it suitable for long-term use as an antiepileptic.


Indications



  • Oral or parenteral: Sedative


  • Oral or parenteral: Hypnotic, treatment of insomnia for up to 2 wk


  • Oral: Long-term treatment of generalized tonic-clonic and cortical focal seizures


  • Oral: Emergency control of certain acute seizures (eg, those associated with status epilepticus, eclampsia, meningitis, tetanus, and toxic reactions to strychnine or local anesthetics)


  • Parenteral: Preanesthetic


  • Parenteral: Treatment of generalized tonic-clonic and cortical focal seizures


  • Parenteral: Emergency control of acute seizures (tetanus, eclampsia, epilepticus)




Available Forms

Tablets—15, 16, 30, 32.4, 60, 64.8, 90, 97.2, 100 mg; capsules—16 mg; elixir—20 mg/5 mL; injection—65, 130 mg/mL


Dosages

Adults

Oral



  • Sedation: 30–120 mg/day PO in two to three divided doses. No more than 400 mg per 24 hr.


  • Hypnotic: 100–320 mg PO at bedtime.


  • Antiepileptic: 60–300 mg/day PO.

IM or IV



  • Sedation: 30–120 mg/day IM or IV in two to three divided doses.


  • Preoperative sedation: 100–200 mg IM, 60–90 min before surgery.


  • Hypnotic: 100–320 mg IM or IV.


  • Acute seizures: 200–320 mg IM or IV repeated in 6 hr if needed.

Pediatric patients

Oral



  • Sedation: 6 mg/kg/day PO in divided doses.


  • Hypnotic: Determine dosage using age and weight charts.


  • Antiepileptic: 3–6 mg/kg/day PO.

IM or IV

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Jul 21, 2016 | Posted by in NURSING | Comments Off on Dangerous Drug: Phenobarbital

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