Drug information of Phenobarbital

Phenobarbital

Drug group: Anticonvulsants

Phenobarbital is a barbiturate (bar-BIT-chur-ate). Phenobarbital slows the activity of your brain and nervous system. Phenobarbital is used to treat or prevent seizures. Phenobarbital is also used short-term as a sedative to help you relax.

Mechanism of effect

Phenobarbital acts on GABAA receptors, increasing synaptic inhibition. Barbiturates depress the sensory cortex, decrease motor activity, alter cerebellar function, and produce drowsiness, sedation, and hypnosis.

Pharmacodynamic

Barbiturates are capable of producing all levels of CNS mood alteration, from excitation to mild sedation, hypnosis, and deep coma. Overdosage can produce death. In high enough therapeutic doses, barbiturates induce anesthesia.

Pharmacokinetics

Barbiturates are absorbed in varying degrees following oral or parenteral administration Barbiturates are weak acids that are absorbed and rapidly distributed to all tissues and fluids, with high concentrations in the brain, liver, and kidneys. Half life:53 to 118 hours (mean 79 hours)

Drug indications

Insomnia , Sedative , Anticonvulsant

Dosage

Usual Adult Dose for Sedation Daytime Sedation: 30 to 120 mg orally, IM, or IV in 2 or 3 divided doses Maximum dose: 400 mg during a 24-hour period Preoperative Sedation: Parenteral: 100 to 200 mg IM 60 to 90 minutes before surgery Usual Adult Dose for Insomnia Oral: -Recommended dose: 100 to 200 mg orally once a day -Maximum dose: 400 mg during a 24-hour period Parenteral: -Recommended dose: 100 to 320 mg IM or IV once a day -Maximum dose: 400 mg during a 24-hour period Usual Adult Dose for Seizures Acute Convulsions Parenteral: 20 to 320 mg IM or IV every 6 hours as necessary Anticonvulsant: Oral: 60 to 200 mg orally per day Usual Pediatric Dose for Seizures Anticonvulsant: Oral: -Initial dose: 15 to 20 mg/kg orally -Recommended dose: 3 to 6 mg/kg orally Parenteral: 4 to 6 mg/kg/day for 7 to 10 days or 5 to 15 mg/kg/day IM or IV Status epilepticus: Parenteral: -Initial dose: 15 to 20 mg/kg IV over 10 to 15 minutes Usual Pediatric Dose for Sedation Parenteral: 1 to 3 mg/kg IM or IV Use: Preoperative sedation

Interactions

Albendazol , Amlodipine/Atorvastatine , Amitriptyline , Ethosuximide , Ergotamine-C , Erlotinib , stiripentol , tolvaptan , tibolone , Aminophenazone , neratinib , vemurafenib , rolapitant , Larotrectinib , glasdegib , Triphasic , Eliglustat , Elvitegravir , rilpivirine , Darolutamide , Pitolisant , cosyntropin , Oxymorphone , ELBASVIR/GRAZOPREVIR , Lorlatinib , Tasimelteon , trabectedine , Duvelisib , tezacaftor/ivacaftor , Alpelisib , Edoxaban , cobicistat , Delavirdine , Sofosbuvir and velpatasvir , Fostamatinib , Apremilast , Acetaminophen and benzhydrocodone , Etravirine , Dabrafenib , Dolutegravir , Acalabrutinib , Maraviroc , Nintedanib , Tinzaparin , Leucovorin , Telaprevir , Simeprevir , lumacaftor and Ivacaftor , Ulipristal , Abiraterone , Alosetron , Dalteparin , Pirfenidone , Canagliflozin , Copanlisib , Mifepristone , Afatinib , Indinavir , Dexmethylphenidate , novafen , brigatinib , Sodium Oxybate , Quinidine , Tapentadol , codeine , Axitinib , Phenindione , fentanyl , Ranolazine , Praziquantel , Darunavir , Donepzil , Buprenorphine , Diltigel , Flecainide , Disulfiram , Valerian , Sofosbuvir , ledipasvir and sofosbuvir , Clozapine , Clonidine , Cholestyramine , Tranquival , valirest , Enzalutamide , Verapamil , Vitamin C , Chloramphenicol , Chlorpromazine , Chlordiaze poxide , Clemastine , Modafinil , Nitrazepam , Nilotinib , Hydrochlorothiazide , Valproate sodium , Sedamin , Folinic acid , Folic acid , Lapatinib , Metronidazole , Metoprolol , Methylprednisolone , Zolpidem , Sunitinib , Sorafenib , Cyclosporine , Cyclophosphamide , Fluticasone propinate , Tinidazole , Thiothixene , Ticlopidine , Deflazacort , Dydrogesterone , Atropine/ diphenoxylate( Lomotil® ) , Tadalafil , Thalidomide , Tacrolimus , Tetracosactid , Triamcinolone , Temozolomide , Imatinib , Buspirone , Achillea millefolium , Propafenone , Propranolol , Protamine sulfat , Acetaminophen , Exemestane , Everolimus , Ipratropium bromide , Irinotecan , Ifosfamide

Alerts

1- Phenobarbital may be habit forming. Tolerance and psychological and physical dependence may occur with continued use 2- Caution should be exercised when barbiturates are administered to patients with acute or chronic pain, because paradoxical excitement could be induced or important symptoms could be masked. 3-Barbiturates can cause fetal damage when administered to a pregnant woman

Points of recommendation

1-The concomitant use of alcohol or other CNS depressants may produce additive CNS depressant effects. 2-Elderly or debilitated patients may react to barbiturates with marked excitement, depression, or confusion. In some persons, especially children, barbiturates repeatedly produce excitement rather than depression.

Pregnancy level

D


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