pentobarbital sodium


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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

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.

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

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.

pentobarbital sodium

(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.
References in periodicals archive ?
Pentobarbital sodium may cause systemic vasodilation and hypotension, which can lead to cerebral hypoperfusion and ischemia.
Pentobarbital sodium therapy is a second-tier treatment for patients whose elevated ICP remains refractory to treatment for a defined time.
Experiment 2: effects of drug on the sleep latency and duration of sleep in pentobarbital sodium treated mice
Animals were administered with pentobarbital sodium (55 mg/kg i.
In this experiment, we investigated the effect of the five differential doses of pentobarbital sodium on sleeping time in mice.
In this model, Salidroside exhibited significant sedative and hypnotic synergistic action with pentobarbital sodium in mice.
Pentobarbital sodium is a barbiturate that induces sleep in both rodents and humans (Koch-Weser and Greenblatt, 1974).
In this study, salidroside showed that not only the shortening effect on the sleep latency, but also prolonging effect on the sleeping time in mice treated with hypnotic dosage of pentobarbital sodium (55mg/kg).