pentobarbital sodium

pen·to·bar·bi·tal sodium

P0174000 (pĕn′tə-bär′bĭ-tôl′, -tăl′)n. A barbiturate, C₁₁H₁₇N₂O₃Na, that takes effect relatively rapidly, used as a sedative, a hypnotic, and an anticonvulsive drug, and for euthanasia. Also called pentobarbitone.

pentobarbital sodium

pentobarbital

pentobarbitone

n (Pharmacology) a barbiturate drug used in medicine as a sedative and hypnotic. Formula: C11H17N2O3Na. US equivalent: sodium pentabarbital

Thesaurus

Noun

pentobarbital sodium - a barbiturate (trade name Nembutal) used as a sedative and hypnotic and antispasmodicNembutal, pentobarbital, yellow jacketbarbiturate - organic compound having powerful soporific effect; overdose can be fatal

pentobarbital sodium

Nembutal Sodium

Pharmacologic class: Barbiturate

Therapeutic class: Sedative-hypnotic, anticonvulsant

Controlled substance schedule II

Pregnancy risk category D

Action

Depresses sensory cortex, decreases motor activity, and alters cerebellar function; may interfere with nerve impulse transmission in brain

Availability

Injection: 50 mg/ml in 2-ml prefilled syringes

Indications and dosages

➣ Preoperative sedation

Adults: Initially, 150 to 200 mg I.M., or 100 mg I.V.

➣ Seizures

Adults: Initially, 100 mg. I.V.; may give additional doses after 1 minute. Maximum dosage is 500 mg.

Children: Initially, 50 mg. I.V.; may give additional doses until desired response occurs. Don't exceed 100 mg/dose.

Contraindications

• Hypersensitivity to drug or other barbiturates

• Nephritis (with large doses)

• Severe hepatic impairment

• Severe respiratory disease with dyspnea or obstruction

• Manifest or latent porphyria

• History of sedative-hypnotic abuse

• Subcutaneous or intra-arterial administration

Precautions

Use cautiously in:

• hepatic or renal impairment, increased risk for suicide, alcohol use

• history of drug addiction

• labor and delivery

• elderly or debilitated patients.

Administration

See When giving I.V., make sure resuscitation equipment is available.

• Give I.V. by direct injection no faster than 50 mg/minute.

• Inject I.M. deep into large muscle mass.

See Don't give by subcutaneous or intra-arterial routes, because severe reactions (such as tissue necrosis and gangrene) may occur.

• Know that drug is for short-term use only, losing efficacy after about 2 weeks.

Adverse reactions

CNS: drowsiness, agitation, confusion, hyperkinesia, ataxia, nightmares, nervousness, hallucinations, insomnia, anxiety, abnormal thinking

CV: hypotension, syncope, bradycardia (all with I.V. use)

GI: nausea, vomiting, constipation

Hepatic: hepatic damage

Musculoskeletal: joint pain, myalgia, neuralgia

Respiratory: laryngospasm (with I.V. use), bronchospasm, respiratory

depression

Skin: rash, urticaria, exfoliative dermatitis

Other: phlebitis at I.V. site, physical or psychological drug dependence, fever, hypersensitivity reactions including angioedema

Interactions

Drug-drug. Acetaminophen: increased risk of hepatotoxicity

Activated charcoal: decreased pentobarbital absorption

Anticoagulants, beta-adrenergic blockers (except timolol), carbamazepine, clonazepam, corticosteroids, digoxin, doxorubicin, doxycycline, felodipine, fenoprofen, griseofulvin, hormonal contraceptives, metronidazole, quinidine, theophylline, verapamil: decreased efficacy of these drugs

Antihistamines (first-generation), opioids, other sedative-hypnotics: additive CNS depression

Chloramphenicol, hydantoins, narcotics: increased or decreased effects of either drug

Divalproex, MAO inhibitors, valproic acid: decreased pentobarbital metabolism, increased sedation

Rifampin: increased pentobarbital metabolism and decreased effects

Drug-diagnostic tests. Sulfobromoph-thalein: false increase

Drug-herbs. Chamomile, hops, kava, valerian, or skullcap: increased CNS depression

St. John's wort: decreased pentobarbital effects

Drug-behaviors. Alcohol use: increased sedation, additive CNS depression

Patient monitoring

See Closely monitor blood pressure and heart and respiratory rates. Watch for evidence of respiratory depression.

• Monitor neurologic status before and during therapy.

• Assess CBC and kidney and liver function tests.

• In long-term therapy, monitor patient for signs of drug dependence.

Patient teaching

• Advise patient to avoid other CNS depressants, alcohol, and herbs.

• Caution patient to avoid driving and other hazardous activities.

• Advise patient taking hormonal contraceptives to use alternate birth-control method during therapy.

• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, tests, herbs, and behaviors mentioned above.