Pentobarbital

Administration

  • Type: Anticonvulsant, Barbiturate; Barbiturate
  • Routes of Administration: IV, IM
  • Common Trade Names: Nembutal

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

  • Pregnancy Rating: D

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

  • respiratory depression
  • Stevens-Johnson syndrome
  • angioedema
  • lupus erythematosus

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

References

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