Phenobarbital


Thông tin thuốc gốc
Chỉ định và Liều dùng
Intramuscular
Preoperative sedation
Adult: As phenobarbital Na: 100-200 mg 60-90 min pre-op.
Child: As phenobarbital Na: 16-100 mg 60-90 min pre-op.
Elderly: Reduce dose.

Intravenous
Preoperative sedation
Child: 1-3 mg/kg pre-op.

Oral
Emergency management of acute seizures, Status epilepticus
Adult: 100-300 mg daily at bedtime.
Child: 3-5 mg/kg or 125 mg/m2 daily.
Elderly: Reduce dose.

Oral
Hypnotic
Adult: 100-320 mg. Do not admin for >2 wk for the treatment of insomnia.
Elderly: Reduce dose.

Oral
Preoperative sedation
Child: 1-3 mg/kg pre-op.

Oral
Sedation
Adult: 30-120 mg daily in 2-3 divided doses.
Child: 6 mg/kg daily or 180 mg/m2 daily in 3 divided doses.
Elderly: Reduce dose.

Parenteral
Hypnotic
Adult: 100-320 mg. Do not admin for >2 wk for the treatment of insomnia.
Elderly: Reduce dose.

Parenteral
Emergency management of acute seizures, Status epilepticus
Adult: As phenobarbital Na: 200-600 mg.
Child: As phenobarbital Na: 100-400 mg.
Elderly: Reduce dose.
Special Patient Group
Debilitated patient: Reduce dose.
Renal Impairment
Reduce dose. Severe: Contraindicated.
Hepatic Impairment
Reduce dose. Severe: Contraindicated.
Cách dùng
May be taken with or without food.
Hướng dẫn pha thuốc
Dilute w/ most IV infusion soln (e.g. NaCl 0.45% or 0.9%, lactated Ringer's, dextrose 5%, Ringer's).
Tương kỵ
Y-site: Pantoprazole, amphotericin B cholesteryl sulfate complex. Syringe: Ranitidine, hydromorphone, sufentanil.
Chống chỉ định
Severe resp depression, acute intermittent porphyria. Severe renal and hepatic impairment. Intra-arterial and SC admin.
Thận trọng
Patient w/ history or sedative/hypnotic addiction; resp disease, depression or suicidal tendencies, hypoadrenalism. Avoid abrupt withdrawal. Mild to moderate renal and hepatic impairment. Elderly or debilitated patient, childn. Pregnancy and lactation.
Phản ứng phụ
Bradycardia, syncope, hypotension; anxiety, agitation, ataxia, CNS excitation or depression, confusion, dizziness, drowsiness, hallucinations, hangover effect, headache, hyperkinesias; constipation, nausea, vomiting; agranulocytosis, thrombocytopenia, megaloblastic anaemia; oliguria; pain at inj site, thrombophlebitis (w/ IV use); laryngospasm, resp depression, apnoea (esp w/ rapid IV use), hypoventilation; gangrene (w/ unintentional intra-arterial inj).
Potentially Fatal: Stevens-Johnson syndrome, toxic epidermal necrolysis.
IM/IV/Parenteral/PO: D
Thông tin tư vấn bệnh nhân
May impair ability to drive or operate machinery.
MonitoringParameters
Monitor CBC, LFTs, mental status and seizure activity.
Quá liều
Symptoms: Drowsiness, dysarthria, ataxia, nystagmus, disinhibition, hypotension, hypotonia, hyporeflexia, hypothermia, absent bowel sounds, cardiac arrest, resp and CV depression, shock leading to renal failure, prolonged coma. Management: Symptomatic and supportive treatment. Admin activated charcoal w/in 1 hr prior to ingestion. Maintain adequate airway. Admin dopamine or dobutamine in severe hypotension. Perform haemodialysis or charcoal haemoperfusion in renal failure.
Tương tác
May reduce plasma levels of oral anticoagulants (e.g. warfarin, dicoumarol, acenocoumarol, phenprocoumon), corticosteroids, griseofulvin, doxycycline, Na valproate and valproic acid. May increase CNS depressant effect w/ phenytoin, antihistamines, sedative/hypnotics, tranquilisers. May prolong the effect w/ MAOIs. May reduce the effect of estradiol, progesterone, estrone and other steroidal hormones.
Food Interaction
May enhance CNS depressant effect of alcohol. May reduce the effect w/ St John's wort.
Lab Interference
May interfere w/ the results of metyrapone test, serum bilirubin estimation and phenlolamine test.
Tác dụng
Description: Phenobarbital is a long-acting barbiturate. It depresses the sensory cortex, reduces motor activity, changes cerebellar function and produces drowsiness, sedation and hypnosis. Its anticonvulsant property is exhibited at high doses.
Onset: Hypnosis: 20-60 min (oral); approx 5 min (IV).
Duration: 6-10 hr (oral); 4-10 hr (IV).
Pharmacokinetics:
Absorption: Readily absorbed from the GI tract. Time to peak plasma concentration: Approx 2 hr (oral); w/in 4 hr (IM).
Distribution: Crosses the placenta; enters breast milk. Plasma protein binding: Approx 45-60%.
Metabolism: Undergoes partial hepatic metabolism via hydroxylation and glucuronide conjugation.
Excretion: Via urine (approx 25% as unchanged drug). Plasma half-life: Approx 75-120 hr.
Đặc tính

Chemical Structure Image
Phenobarbital

Source: National Center for Biotechnology Information. PubChem Database. Phenobarbital, CID=4763, https://pubchem.ncbi.nlm.nih.gov/compound/Phenobarbital (accessed on Jan. 22, 2020)

Bảo quản
Store between 20-25°C.
Phân loại ATC
N03AA02 - phenobarbital ; Belongs to the class of barbiturates and derivatives antiepileptics.
References
Anon. Phenobarbital. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 07/11/2014.

Buckingham R (ed). Phenobarbital. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 07/11/2014.

McEvoy GK, Snow EK, Miller J et al (eds). Phenobarbital, Phenobarbital Sodium (Anticonvulsant). AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 07/11/2014.

McEvoy GK, Snow EK, Miller J et al (eds). Phenobarbital, Phenobarbital Sodium (Sedative). AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 07/11/2014.

Phenobarbital Elixir (Qualitest Pharmaceuticals). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 07/11/2014.

Phenobarbital Sodium Injection (West-ward Pharmaceutical Corp.). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 07/11/2014.

Phenobarbital Tablet (American Health Packaging). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 07/11/2014.

Thông báo miễn trừ trách nhiệm: Thông tin này được MIMS biên soạn một cách độc lập dựa trên thông tin của Phenobarbital từ nhiều nguồn tài liệu tham khảo và được cung cấp chỉ cho mục đích tham khảo. Việc sử dụng điều trị và thông tin kê toa có thể khác nhau giữa các quốc gia. Vui lòng tham khảo thông tin sản phẩm trong MIMS để biết thông tin kê toa cụ thể đã qua phê duyệt ở quốc gia đó. Mặc dù đã rất nỗ lực để đảm bảo nội dung được chính xác nhưng MIMS sẽ không chịu trách nhiệm hoặc nghĩa vụ pháp lý cho bất kỳ yêu cầu bồi thường hay thiệt hại nào phát sinh do việc sử dụng hoặc sử dụng sai các thông tin ở đây, về nội dung thông tin hoặc về sự thiếu sót thông tin, hoặc về thông tin khác. © 2021 MIMS. Bản quyền thuộc về MIMS. Phát triển bởi MIMS.com
  • Gardenal
  • Gardenal oral
  • Phenobarbital Danapha
Register or sign in to continue
Asia's one-stop resource for medical news, clinical reference and education
Sign up for free
Already a member? Sign in