secobarbital

secobarbital /se·co·bar·bi·tal/ (se″ko-bahr´bĭ-tal) a short-acting barbiturate used as the sodium salt as a hypnotic and sedative and as an anticonvulsant in tetanus.

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sec·o·bar·bi·tal (sk-bärb-tôl, -tl)

n.

A white, odorless barbiturate used in the form of its sodium salt as a sedative and hypnotic.

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secobarbital

a short- to intermediate-acting oxybarbiturate, used for sedation and anesthesia. Called also quinalbarbitone.

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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.

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secobarbital

Neuropharmacology An intermediate-acting sedative and hyponotic, replaced by benzodiazepines Adverse effects Prolonged drowsiness, parodoxic excitement, diffuse arthritis, myalgic, or neuralgic pain, hypersensitivity in Pts with upregulated immunity–eg, with asthma, angioedema, urticaria, drug interactions–eg, MAOIs, INH, ethanol; stimulation of hepatic microsomal enzymes may ↑ metabolism of drugs, endogenous steroids, and certain anesthetics Pharmacologic effects Like phenobarbital Used for Anxiolytic, relieves insomnia; pre-anesthesia