Hypersensitivity to phenobarbital, barbiturates, or any component of the formulation
Marked hepatic impairment
Porphyria
Nephritic patients (large doses)
Dyspnea or airway obstruction
Intra-arterial or SubQ administration
Use in patients with a history of sedative/hypnotic substance use disorder
Adult dosages
CCP: Refractory status epilepticus
15 mg/kg IV
Pediatric Considerations And Dosing
CCP: Refractory status epilepticus
15 mg/kg, maximum 1000 mg
Mechanism Of Action
Long-acting barbiturate with sedative, hypnotic, and anticonvulsant properties. Barbiturates depress the sensory cortex, decrease motor activity, alter cerebellar function, and produce drowsiness, sedation, and hypnosis. In high doses, barbiturates exhibit anticonvulsant activity; barbiturates produce dose-dependent respiratory depression.
Respiratory: Apnea (especially with rapid IV use), hypoventilation, respiratory depression
Warning And Precautions
CNS depression: May cause CNS depression which may impair physical or mental abilities; patients must be cautioned about performing tasks which require mental alertness
Hypersensitivity: Exfoliative dermatitis and Stevens-Johnson syndrome, possibly fatal, may occur; discontinue if dermatological reactions occur
Paradoxical stimulatory response: May cause paradoxical responses, including agitation and hyperactivity, particularly in patients with acute or chronic pain, and pediatric patients
Respiratory depression: May cause respiratory depression particularly when administered intravenously; use with caution in patients with respiratory disease
Drug Interactions
Depressant effects are potentiated by the presence of other CNS depressants such as alcohol, sedatives, antihistaminics, or psychotropic drugs
Patients on neuroleptics: Morphine may increase the risk of respiratory depression, hypotension, and profound sedation or coma