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)
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 (may be ineffective and may contribute to further addiction), pregnancy (fetal damage, neonatal withdrawal syndrome).
Use cautiously with acute or chronic pain (drug may cause paradoxic excitement or mask important symptoms); seizure disorders (abrupt discontinuation of daily doses can result in status epilepticus); lactation (secreted in breast milk; drowsiness in breast-feeding infants); fever, hyperthyroidism, diabetes mellitus, severe anemia, pulmonary or cardiac disease, status asthmaticus, shock, uremia, impaired liver or renal function, debilitation.
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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