Seconal

Sec·o·nal (sk-nôl, -nl, -nl)

A trademark for the drug secobarbital.

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secobarbital

Seconal

Pharmacologic class: Barbiturate

Therapeutic class: Sedative-hypnotic, preanesthetic

Controlled substance schedule II

Pregnancy risk category D

Action

Depresses sensory cortex, decreases motor activity, alters cerebellar function, and produces drowsiness, sedation, and hypnosis

Availability

Capsules: 100 mg

⊘Indications and dosages

➣ Insomnia

Adults: 100 mg P.O. at bedtime

➣ Preanesthetic sedation

Adults: 200 to 300 mg P.O. 1 to 2 hours before surgery

Children: 2 to 6 mg/kg (maximum of 100 mg) P.O. 1 to 2 hours before surgery

Dosage adjustment

• Renal impairment
• Elderly or debilitated patients

Contraindications

• Hypersensitivity to drug or other barbiturates
• Marked hepatic impairment
• Respiratory disease with obvious dyspnea or obstruction
• History of manifest or latent porphyria

Precautions

Use cautiously in:
• patients with suicidal tendencies or a history of substance abuse
• mild hepatic impairment
• alcohol use
• elderly patients
• labor and delivery
• pregnant or breastfeeding patients.

Administration

• Give with or without food when used for insomnia; give without food when used for preanesthetic sedation.

Route	Onset	Peak	Duration
P.O.	10-15 min	Unknown	3-4 hr

Adverse reactions

CNS: somnolence

CV: bradycardia, hypotension, syncope

Hepatic: hepatic damage

Respiratory: hypoventilation

Skin: exfoliative dermatitis, angioedema

Other: drug dependence or tolerance, hypersensitivity reaction

Interactions

Drug-drug. Corticosteroids: enhanced metabolism of these drugs

Doxycycline: shortened doxycycline half-life

Estradiol: increased estradiol metabolism

Griseofulvin (oral): interference with griseofulvin absorption

MAO inhibitors: prolonged barbiturate activity

Oral anticoagulants: decreased anticoagulant response

Other CNS depressants (such as antihistamines, narcotics, tranquilizers): additive CNS depression

Phenytoin: increased or decreased phenytoin blood level

Valproic acid derivatives: increased secobarbital blood level

Drug-herbs. St. John's wort: decreased secobarbital blood level

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

Patient monitoring

☞ Closely monitor blood pressure and heart and respiratory rates. Watch for signs and symptoms of respiratory depression, especially with preoperative use.
• Assess CBC and kidney and liver function tests.
• In long-term therapy, monitor patient for drug dependence.

Patient teaching

• Tell patient to take only as prescribed. Caution him that drug is habit forming.
• Advise patient to avoid alcohol, St. John's wort, and other CNS depressants during drug therapy.
• Caution patient to avoid driving and other hazardous activities.
• Advise patient taking hormonal contraceptives to use alternative birth control method.
• As appropriate, review all other significant and life-threatening adverse reactions and interactions, especially those related to the drugs, herbs, and behaviors mentioned above.