Phenobarbitol (Phenobarb) Uses :Control terminal seizures; Sedation; Agitation refractory to other meds in end of life; Adjuvant in pain due to CNS origin; Epilepsy

Pointers

tablet may be crushed dilute inj in 10 times in water

HL 2-6 days so can be given as single dose as HS, anticonvulsant therapeutic level 15-40 mcg/L bioavailability 70-90%,

IV onset 5 min, duration 4-6 hrs, peak 8-12 hrs

inactive metabolized by liver, excreted major in urine

Side effects

resp depression (IV), ataxia, dizziness, drowsiness, confusion,

Available

Tab 15, 30, 60, 100 mg. Elixer 20 mg/5 ml. Inj 30,60,65,130 mg/ml

Rx

Loading : 20 mg/kg/dose oral, IV, IM, SQ at 25-60 mg/min max 1200 mg/24 hrs maintenance for seizures 1-3 mg/kg/d PO/IV div bid or tid sedation: 30-120 mg/d divided BID / TID max 400 mg/d Hypnotic / insomnia : 100-200 mg/ HS  (max 400 mg/d)