Pentobarbital: functions, dosage, side effects, how to use

What Drug Pentobarbital?

What is pentobarbital for?

Pentobarbital is a drug that belongs to a group of drugs called barbiturates. Pentobarbital slows down the activity of the brain and nervous system.

Pentobarbital is used short term to treat insomnia. Pentobarbital is also used as an emergency treatment for seizures, and causes you to fall asleep during surgery.

Pentobarbital can also be used for other purposes not listed in the medication guide.

How to use pentobarbital?

Pentobarbital is given as an injection into a muscle or vein. Your doctor, nurse, or health care provider will give you this injection. You can see how to inject your medicine at home. Do not inject this medication yourself if you do not fully understand how to administer the injection and properly dispose of needles, IV tubes, and other items used to administer drugs.

When injected into a vein, pentobarbital must be given slowly.

Use a disposable needle only once. Discard used needles in leak-proof containers (ask your pharmacist where you can get one and how to dispose of it). Keep this container out of reach of children and pets.

Do not suddenly stop taking pentobarbital after using it for a long time, or you could have unpleasant withdrawal symptoms. Discuss with your doctor how to avoid withdrawal symptoms when you stop taking pentobarbital.

To make sure this medicine is not causing harmful effects, you may need to have regular blood tests. You may also have to check your kidney or liver function. Don't miss any follow-up visits with your doctor.

How is pentobarbital stored?

This medication is best stored at room temperature, away from direct light and damp places. Don't keep it in the bathroom. Don't freeze it. Other brands of this drug may have different storage rules. Observe the storage instructions on the product package or ask your pharmacist. Keep all medicines away from children and pets.

Do not flush medicines down the toilet or down the drain unless instructed to do so. Discard this product when it has expired or when it is no longer needed. Consult your pharmacist or local waste disposal company about how to safely dispose of your product.

Pentobarbital dosage

The information provided is not a substitute for medical advice. ALWAYS consult your doctor or pharmacist before starting treatment.

What is the pentobarbital dosage for adults?

Normal Dosage for Adults with Insomnia

Ready-to-drink capsule or elixir: 100 mg to drink immediately at bedtime.

Rectal apparatus: 120-200 mg administered rectally

Injection: 100 to 200 mg IM or IV.

Normal Dose for Sedation Adults

Ready-to-drink capsule or elixir: 100 mg to drink immediately at bedtime.

Rectal apparatus: 120-200 mg inserted through the rectal canal

Injection: 100 to 200 mg IM or IV.

What is the dose of pentobarbital for children?

Normal Dose of Sedation for Children

Procedural (moderate) sedation:

Oral:

Infants: 4 mg / kg by mouth immediately followed by 2 to 4 mg / kg every 30 minutes if needed

Maximum dose: 8 mg / kg orally

Infants and Children:

IM: 2 to 6 mg / kg

IM maximum dose: 100 mg

IV: Initially 1 to 2 mg / kg; additional doses from 1 to 2 mg / kg every 3 to 5 minutes for the desired effect; usually the total effective dose is 1 to 6 mg / kg

Maximum IV dose: 100 mg / dose Note: Patients receiving concurrent barbiturate therapy may require a higher total mg / kg dose (up to 9 mg / kg).

Children:

Oral, rectal:

Less than 4 years: 3-6 mg / kg

Maximum dose: 100 mg

4 years and over: 1.5 to 3 mg / kg

Maximum dose: 100 mg

Adolescents: IV: 100 mg before procedure

Increased ICP reduction:

IV: Note: Intubation is required; dosage should be adjusted according to hemodynamics, ICP, cerebral perfusion pressure, and EEG.

Low dose: Children and adolescents: 5 mg / kg every 4 to 6 hours

High doses of pentobarbital coma:

Children and Adolescents: Loading dose 10 mg / kg over 30 minutes, then 5 mg / kg every hour for 3 hours; initial maintenance of infusion: 1 mg / kg / hour; adjusts to maintaining emphasis on the EEG; Maintenance dose range: 1 to 2 mg / kg / hour

Sedation in a mechanically ventilated ICU patient (who has failed standard therapy):

IV: Infants, Children, and Adolescents: Loading dose 1 mg / kg followed by 1 mg / kg / hour infusion. Additional boluses at a dose equal to the hourly rate can be given every 2 hours as needed. If greater than or equal to 4 to 6 boluses are given within 24 hours, then increase the maintenance rate by 1 mg / kg / hour; Required range: 1-6 mg / kg / hour (median: 2 mg / kg / hour). Tapered doses and / or conversion to oral phenobarbital have been reported for therapy longer than or equal to 5 days.

Normal Dosage for Children With Status Epilepticus

Status epilepticus refractory to standard therapy:

Note: Intubation is required; the dose should be adjusted according to hemodynamics, seizure activity, and EEG.

IV:

Infants, Children and Adolescents:

Dosage: 5 mg / kg

Maintenance infusion: Initial: 1 mg / kg / hour, may be increased to 3 mg / kg / hour (usual range: 1 to 3 mg / kg / hour); maintaining the pressure-inducing explosion in the EEG for 12 to 48 hours (no seizure activity), purifying a pentobarbital use rate of 0.5 mg / kg every 12 hours has been reported.

High doses of pentobarbital coma:

IV:

Infants and Children: Loading dose 10 to 15 mg / kg given slowly over 1 to 2 hours; monitor blood pressure and respiratory rate.

Maintenance of infusion: Initial: 1 mg / kg / hour; can be increased to 5 mg / kg / hour (usual range: 0.5 to 3 mg / kg / hour); maintains the blast pressure at the EEG.

Note: Loading doses of 20 to 35 mg / kg (given over 1 to 2 hours) have been used in pediatric patients for pentobarbital coma, but these doses are higher and often cause hypotension requiring vasopressor therapy.

In what dosage is pentobarbital available?

Solution, injection, sodium: 50 mg / mL (20 mL, 50 mL)

Pentobarbital side effects

What side effects can be experienced due to pentobarbital?

Seek emergency medical help if you have any of the following signs of an allergic reaction: hives; difficulty breathing; swelling of your face, lips, tongue, or throat.

Call your doctor at once if you have serious side effects such as:

• confusion, hallucinations
• weakness or shortness of breath
• slow heart rate, weak pulse
• feeling like you might pass out

Less serious side effects may include:

• problems with memory or concentration
• excitement, irritability, or aggression (especially in children or older adults)
• loss of balance or coordination
• nightmare
• nausea, vomiting, constipation

• headache
• the "hangover" effect (drowsiness after taking the drug)

Not everyone experiences this side effect. There may be some side effects not listed above. If you have any concerns about side effects, please consult a doctor or pharmacist.

Pentobarbital Drug Warnings and Cautions

What should be known before using pentobarbital?

Before using pentobarbital,

• tell your doctor and pharmacist if you are allergic to pentobarbital, aspirin, tartrazine (a yellow dye in some processed foods and medicines), or any other medication
• tell your doctor and pharmacist what prescription and medication you are taking, especially acetaminophen (Tylenol), antihistamines, chloramphenicol (Chloromycetin), digitoxin (Crystodigin), diuretics ('water pill'), doxycycline (Vibramycin), griseofulvin (Grisactin) nonprescription, drugs for depression or seizures, metronidazole (Flagyl), oral contraceptives, propranolol (Inderal), quinidine, rifampin, sedatives, sleeping pills, steroids (for asthma), theophylline (Theo-Dur), sedatives, and vitamins
• tell your doctor if you have a fever or illness or if you have or have ever had liver or kidney disease, asthma, hyperthyroidism, diabetes, anemia, a history of alcoholism or drug abuse, or heart or lung problems
• tell your doctor if you are pregnant, plan to become pregnant, or are breastfeeding. If you become pregnant while taking pentobarbital, call your doctor
• if you are having surgery, including dental surgery, tell your doctor or dentist if you are taking pentobarbital.
• You should know that this drug may make you drowsy. Do not drive a car or operate machinery until you know how this drug affects you.

Is pentobarbital safe for pregnant and lactating women?

There are no adequate studies regarding the risks of using this drug in pregnant or breastfeeding women. Always consult your doctor to weigh the potential benefits and risks before using this medication. This drug is included in the risk of pregnancy category D according to the US Food and Drug Administration (FDA).

The following references the pregnancy risk categories according to the FDA:

• A = No risk,
• B = not at risk in several studies,
• C = May be risky,
• D = There is positive evidence of risk,
• X = Contraindicated,
• N = Unknown

Pentobarbital is excreted into breast milk in small amounts. The possibility of accumulation of other barbiturates in nursing infants has been reported, although pentobarbital has not been specifically involved. The American Academy of Pediatrics does not place pentobarbital in a formal position but classifies phenobarbital as a drug that "causes significant effects in some breastfed babies and should be given to nursing mothers with caution".

Pentobarbital Drug Interactions

What medicines may interact with pentobarbital?

Most reports of clinically significant drug interactions with barbiturates usually involve phenobarbital. However, the application of these data to other barbiturates is likely to be valid and requires a series of relevant drugs when multiple therapies are present.

Anticoagulants: Phenobarbital decreases plasma levels of dicumarol (previously used name: bishydroxycoumarin) and causes decreased anticoagulant activity as measured by prothrombin time. Barbiturates can induce liver microsomal enzymes so that metabolism increases and there is a decreased response to oral anticoagulant anticoagulants (eg, warfarin, acenocoumarol, dicumarol, and phenprocoumon). Patients stable on anticoagulant therapy may require dose adjustments if barbiturates are added or withdrawn from their dosing regimen.

Corticosteroids: Barbiturates appear to increase exogenous corticosteroid metabolism possibly through induction of hepatic microsomal enzymes. Patients stable on corticosteroid therapy may require dose adjustments if barbiturates are added or withdrawn from their dosing regimen.

Griseofulvin: Phenobarbital seems to interfere with oral absorption of griseofulvin, thereby lowering blood levels. The resultant effect of lowering griseofulvin blood levels on therapeutic response has not been established. However, it would be better to avoid giving this drug. simultaneously .

Doxycycline: Phenobarbital has been shown to shorten the half-life of doxycycline by 2 weeks after barbiturate therapy is discontinued.

This mechanism may be through the induction of hepatic microsomal enzymes that metabolize antibiotics. If phenobarbital and doxycycline are given concurrently, the clinical response to doxycycline should be closely monitored.

Phenytoin, sodium valproate, valproic acid: The effect of barbiturates on phenytoin metabolism appears to be in several variables. Some investigators reported an accelerated effect, while others reported no effect. Since the effect of barbiturates on phenytoin metabolism is unpredictable, phenytoin and barbiturate blood levels should be monitored more frequently if these drugs are given concurrently. Sodium valproate and valproic acid appear to decrease barbiturate metabolism. Therefore, the barbiturate blood level should be monitored and appropriate dose adjustments made as has been indicated.

Central nervous system depressants: Concomitant use of other central depressants of the nervous system, including other sedatives or hypnotics, antihistamines, sedatives, or alcohol, can produce addictive depressant effects.

Monoamine oxidase inhibitor (MAOI): MAOIs prolong the effect of barbiturates possibly because barbiturate metabolism is inhibited.

Estradiol, estrone, progesterone and other steroid hormones: Pretreatment with or concurrent use of phenobarbital may reduce the effects of estradiol by increasing metabolism. There have been reports of patients treated with antiepileptic drugs (eg, phenobarbital) developing pregnancy while using oral contraceptives. An alternative method of contraception may be recommended for women taking phenobarbital.

Can food or alcohol interact with pentobarbital?

Certain medications should not be used at or around the time of eating foods or eating certain types of food because interactions can occur. Using alcohol or tobacco with certain drugs can also cause interactions to occur. Talk to your healthcare professional about using drugs with food, alcohol, or tobacco.

What health conditions can interact with pentobarbital?

There are 13 disease interactions with pentobarbital:

• acute alcohol intoxication
• drug dependence
• liver disease
• porphyria
• rash
• respiratory depression
• cardiovascular
• prolonged hypotension
• adrenal insufficiency
• depression
• hematological poisoning
• osteomalacia
• paradoxical reactions

Pentobarbital overdose

What should I do in an emergency or overdose?

In case of an emergency or overdose, contact the local emergency services provider (112) or immediately to the nearest hospital emergency department.

What should I do if I miss a dose?

If you forget a dose of this medicine, take it as soon as possible. However, when it is nearing the time of the next dose, skip the missed dose and return to the usual dosing schedule. Don't double the dose.

Hello Health Group does not provide medical advice, diagnosis or treatment.