Pentobarbital

Administration

Adult Dosing

  • Barbiturate coma: 1-3mg/kg/h IV
    • Start: 10-15mg/kg IV x1, then 1mg/kg/h IV
    • Taper dose gradually to discontinue if long-term use

Pediatric Dosing

  • Procedural sedation: 2-6mg/kg IM x1
    • Max: 100mg/dose
    • Onset: 10-15min IM, 1min IV; duration: 1-4h IM, 15min IV
  • Barbiturate coma: 1-3mg/kg/h IV
    • Start: 10-15mg/kg IV x1, then 1mg/kg/h IV
    • Taper dose gradually to discontinue if long-term use

Special Populations

Renal Dosing

  • Renal impairment: decrease start dose

Hepatic Dosing

  • Hepatic impairment: decrease start dose

Contraindications

  • Allergy to class/drug
  • Depressed respiratory function
  • Porphyria
  • Avoid abrupt withdrawal (long-term use)

Adverse Reactions

Serious

Common

  • somnolence
  • agitation
  • confusion
  • hyperkinesia
  • ataxia
  • CNS depression

Pharmacology

  • Half-life: 15-50 hrs
  • Metabolism: CYP450
  • Excretion: Urine

Mechanism of Action

alters sensory cortex, cerebellar, and motor activities; produces sedation, hypnosis, and anesthesia

Comments

See Also

References