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pentobarbital (Nembutal)

Tradename: Nembutal. DEA-controlled substance: class 2. Indications: - sedation (sedative/hypnotic) - high doses used for treatment of cerebral hypoxia - increased intracranial pressure - seizures, status epilepticus* - general anesthesia* [3] - tetanus * endotracheal intubation & mechanical ventilation [3] Dosage: 30-150 mg PO/IV/IM/PR TID/QID. Pediatrics: 2-6 mg/kg/day. Tabs: 50 & 100 mg. Suppositories: 30, 60, 120, 200 mg. Adverse effects: 1) CNS depression 2) confusion 3) drowsiness 4) ataxia 5) coma 6) respiratory depression 7) shock 8) urticaria 9) tolerance & physical dependence Drug interactions: -> coadministration of valproic acid may increase barbiturate concentrations Laboratory: 1) specimen: a) serum, plasma (heparin, EDTA) b) stable refrigerated or frozen 2) methods: GLC, GC-MS, HPLC, EIA 3) interferences: EIA: secobarbital, phenobarbital 4) labs with Loincs - pentobarbital in specimen - pentobarbital in hair - pentobarbital in tissue - pentobarbital in body fluid - pentobarbital in gastric fluid - pentobarbital in saliva - pentobarbital in serum/plasma/blood - pentobarbital in blood - pentobarbital in serum/plasma - pentobarbital in stool - pentobarbital in meconium - pentobarbital in urine

Interactions

drug interactions drug adverse effects (more general classes)

General

sedative/hypnotic (tranquilizer)

Properties

MISC-INFO: elimination route LIVER KIDNEY 1/2life 15-28 HOURS therapeutic-range 1-5 UG/ML 20-50 UG/ML protein-binding 65% elimination by hemodialysis - hemoperfusion + pregnancy-category D safety in lactation ?

Database Correlations

PUBCHEM correlations

References

  1. The Pharmacological Basis of Therapeutics, 9th ed. Gilman et al, eds. Permagon Press/McGraw Hill, 1996
  2. Clinical Guide to Laboratory Tests, 3rd ed. Teitz ed., W.B. Saunders, 1995
  3. Medical Knowledge Self Assessment Program (MKSAP) 20 American College of Physicians, Philadelphia 2025

Component-of

belladonna alkaloid/caffeine/ergotamine/pentobarbital caffeine/ergotamine/pentobarbital (Cafergot PB) pentobarbital/phenytoin