Classes
DEA Class; Rx
Common Brand Names; Nembutal
- Sedative/Hypnotics;
- Barbiturates
Description
Short-acting oral and parenteral barbiturate; for preoperative anxiety, sedation, refractory seizures, or to induce coma for increased intracranial pressure; rarely used for insomnia due to rapid development of tolerance; close monitoring for emerging or worsening suicidal thoughts/behavior or depression is recommended.
Indications
Indicated for procedural sedation or for use as a preanesthetic medication.
Contraindications
Hypersensitivity to barbiturates or excipients
History of latent porphyria
Adverse Effects
Angioedema (rare)
Bradycardia
Hypotension
Agitation
Ataxia
CNS depression
Confusion
Dizziness
Fever
Headache
Hyperkinesia
Nightmares
Nervousness
Somnolence (frequent)
Syncope
Rash
Stevens-Johnson syndrome
Constipation
Nausea
Vomiting
Agranulocytosis (rare)
Megaloblastic anemia with prolonged use (rare)
Injury of liver with prolonged use (rare)
SLE
Apnea
Warnings
Too rapid administration may cause respiratory depression, laryngospasm, apnea, or vasodilation with fall in blood pressure
Exercise caution when administered to patients with acute or chronic pain; could result in paradoxical excitement or important symptoms could be masked
The use of barbiturates as sedatives in the postoperative surgical period and as adjuncts to cancer chemotherapy is well established
Administer barbiturates with caution in patients with hepatic damage and at reduced doses initially; barbiturates should not be administered to patients showing the premonitory signs of hepatic coma
Concomitant use of alcohol or other CNS depressants may produce additive CNS depressant effects
Elderly or debilitated patients may react to barbiturates with marked depression, excitement, and confusion; in some patients, barbiturates repeatedly produce excitement rather than depression
Parenteral solutions of barbiturates are highly alkaline; extreme care should be taken to avoid perivascular extravasation or intra-arterial injection; extravascular injection may cause local tissue damage with subsequent necrosis; consequences of intra-arterial injection may vary from transient pain to gangrene of the limb; any complaint of pain in the limb warrants stopping the injection
Pregnancy and Lactation
Barbiturates can cause fetal damage when administered to a pregnant woman; retrospective, case-controlled studies have suggested a connection between maternal consumption of barbiturates and a higher-than-expected incidence of fetal abnormalities
Exercise caution when a barbiturate is administered to a nursing woman; small amounts of barbiturates are excreted in the milk
Maximum Dosage
Specific maximum dosage information not available; individualize dosage based on clinical parameters and serum pentobarbital concentrations.
Specific maximum dosage information not available; individualize dosage based on clinical parameters and serum pentobarbital concentrations.
Specific maximum dosage information not available; individualize dosage based on clinical parameters and serum pentobarbital concentrations. For procedural sedation, doses above 6 mg/kg/dose IM/IV/PO (Max: 100 mg/dose) are not usually necessary.
Specific maximum dosage information not available; individualize dosage based on clinical parameters and serum pentobarbital concentrations. For procedural sedation, doses above 6 mg/kg/dose IM/IV/PO (Max: 100 mg/dose) are not usually necessary.
Specific maximum dosage information not available; individualize dosage based on clinical parameters and serum pentobarbital concentrations. For procedural sedation, doses above 6 mg/kg/dose IM or IV and 8 mg/kg/dose PO (Max: 100 mg/dose) are not usually necessary.
Specific maximum dosage information not available; individualize dosage based on clinical parameters and serum pentobarbital concentrations. For procedural sedation, doses above 6 mg/kg/dose IV are not usually necessary.
How supplied
Pentobarbital sodium
injectable solution: Schedule II
- 50mg/mL
