Phenobarbital: Difference between revisions
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==Special Populations== | ==Special Populations== | ||
*[[Drug Ratings in Pregnancy|Pregnancy Rating]]: | *[[Drug Ratings in Pregnancy|Pregnancy Rating]]: D | ||
*Lactation: | *Lactation: Enters breast milk, use caution | ||
*Renal Dosing | *Renal Dosing | ||
**Adult | **Adult | ||
** | ***GFR < 10, give every 12-16 hours | ||
* | ***HD: Given before HD and 50% dose after HD | ||
** | **Pediatric: GFR < 10, decrease dose by 50% and give every 24 hours | ||
**Pediatric | *Hepatic Dosing: Reduced dose recommended, but no defined protocols | ||
==Contraindications== | ==Contraindications== | ||
*Allergy to class/drug | *Allergy to class/drug | ||
*Marked hepatic impairment | |||
*Porphyria | |||
==Adverse Reactions== | ==Adverse Reactions== | ||
===Serious=== | ===Serious=== | ||
*Hypotension | |||
*Respiratory depression, apnea | |||
*Significant soft tissue injury with subcutaneous or intra-arterial administration | |||
*Agranulocytosis | |||
===Common=== | ===Common=== | ||
*Sedation, respiratory depression | |||
==Pharmacology== | ==Pharmacology== | ||
*Half-life: | *Onset: Oral 20-60 min, IV 5 min | ||
*Metabolism: | *Peak: IV 30 min | ||
*Excretion: | *Half-life: Neonates 45-500 hr, Infants 20-133 hr, Children 37-73 hr, Adults 53-140 hr | ||
*Mechanism of Action: | *Metabolism: Hepatic | ||
*Excretion: Urine | |||
*Mechanism of Action: [[Barbituates]] | |||
==See Also== | ==See Also== | ||
*[[Barbituates]] | |||
*[[Alcohol withdrawal]] | |||
*[[Status epilepticus]] | |||
==Sources== | ==Sources== | ||
*Lexicomp, UpToDate | |||
<references/> | <references/> | ||
[[Category:Drugs]] | [[Category:Drugs]] | ||
Revision as of 19:14, 26 May 2015
General
- Type: Anticonvulsant, barbiturate, barbituates
- Dosage Forms
- 65 mg/mL injection
- 20 mg/5 mL oral solution
- 15, 16.2, 30, 32.4, 60, 64.8, 97.2, 100 mg tab
Adult Dosing
- Status epilepticus
- 20 mg/kg, infuse at 50-100 mg/min
- May repeat once after 10 minutes with additional 5-10 mg/kg
- Alcohol withdrawal / Delirium Tremens
- 130-260 mg IV q15-20 min [1]
- Seizures, maintenance dose
- 50-100 mg bid-tid
Pediatric Dosing
- Status epilepticus
- 20 mg/kg over 10 minutes. May repeat full dose in 15 minutes
- Seizures, maintenance dose
- ≤5 yo: 3-5 mg/kg/day in 1-2 divided doses
- Children > 5 yrs: 2-3 mg/kg/day in 1-2 divided doses
- Adolescents: 1-3 mg/kg/day in 1-2 divided doses
Special Populations
- Pregnancy Rating: D
- Lactation: Enters breast milk, use caution
- Renal Dosing
- Adult
- GFR < 10, give every 12-16 hours
- HD: Given before HD and 50% dose after HD
- Pediatric: GFR < 10, decrease dose by 50% and give every 24 hours
- Adult
- Hepatic Dosing: Reduced dose recommended, but no defined protocols
Contraindications
- Allergy to class/drug
- Marked hepatic impairment
- Porphyria
Adverse Reactions
Serious
- Hypotension
- Respiratory depression, apnea
- Significant soft tissue injury with subcutaneous or intra-arterial administration
- Agranulocytosis
Common
- Sedation, respiratory depression
Pharmacology
- Onset: Oral 20-60 min, IV 5 min
- Peak: IV 30 min
- Half-life: Neonates 45-500 hr, Infants 20-133 hr, Children 37-73 hr, Adults 53-140 hr
- Metabolism: Hepatic
- Excretion: Urine
- Mechanism of Action: Barbituates
See Also
Sources
- Lexicomp, UpToDate
- ↑ Rosenson J, Clements C, Simon B, Vieaux J, Graffman S, Vahidnia F, Cisse B, Lam J, Alter H: Phenobarbital for acute alcohol withdrawal: a prospective randomized double-blind placebo-controlled study. J Emerg Med. 2013 Mar;44(3):592-598.e2. Epub 2012 Sep 19.