PHENOBARBITAL

BRAND NAMES:
Luminal® Sodium; Barbita; Solfoton

AVAILABLE FORMS:
Capsule: 16 mg
Elixir*: 15 mg/5 ml, 20 mg/5 ml
Injection: 30 mg/ml, 60 mg/ml, 65 mg/ml, 130 mg/ml
Tablets: 15 mg, 16 mg, 30 mg, 60 mg, 100 mg

INDICATIONS:
 All forms of epilepsy, febrile seizure
 Status epilepticus
 Sedation
 Insomia
 Perioperative sedation

ADVERSE REACTION:
CNS: drowsiness, lethargy, hangover, paradoxical excitement in elderly patients, somnolence, changes in EEG pattern
CV: bradycardia, hypotension
GI: nausea, vomiting
Hematologic: exacerbation of porphyria
Respiratory: respiratory depression
Skin: rash, erythema multiforme, Steven’s Johnson syndrome, urticaria, pain, swelling, necrosis
Other: angioedema

MECAHANISM OF ACTION:
It is a barbiturate, nonselective central nervous system depressant which is primarily used as a sedative hypnotic and also as an anticonvulsant in subhypnotic doses. is in a group of drugs called barbiturates (bar-BIT-chur-ates). Phenobarbital slows the activity of your brain and nervous system. It depresses monosynaptic and polysunaptic transmission in CNS and increases threshold for seizure activity in motor cortex. As sedative, drug probably interferes with transmission of impulses from thalamus to cortex of brain.

CONTRAINDICATIONS:
Do not use this medication without telling your doctor if you are pregnant. It could cause harm to the unborn baby. Use an effective form of birth control, and tell your doctor if you become pregnant during treatment.Contraindicated in patients hypersensitive to barbiturates and I those with the history of manifest or latent porphyria; in clients with hepatic dysfunction, respiratory disease with dyspnea or obstruction or nephritis.

EFFECTS ON LAB TEST RESULT:
May decrease bilirubin levels.

NURSING CONSIDERATTION:
1. Do not stop using phenobarbital without first talking to your doctor, even if you feel better. You may have increased seizures if you stop using phenobarbital suddenly.
2. Take phenobarbital only when you are getting ready for several hours of sleep. You may fall asleep very quickly after taking the medicine.
3. Phenobarbital can make birth control pills less effective. Ask your doctor about using a non-hormone method of birth control (such as a condom, diaphragm, spermicide) to prevent pregnancy while taking phenobarbital.
4. Phenobarbital can pass into breast milk and may harm a nursing baby. Do not use this medication without telling your doctor if you are breast-feeding a baby.
5. Phenobarbital can cause side effects that may impair your thinking or reactions. Be careful if you drive or do anything that requires you to be awake and alert.
6. Avoid drinking alcohol. It can increase some of the side effects of phenobarbital.
7. Do not use injectable solution if it contains a precipitate.
8. Give I.M. injection deeply. Superficial injection may cause pain, abscess and tissue sloughing.
9. Elderly patients are more sensitive to drug’s effect.
10. Inform client that full therapeutic effects aren’t seen for 2 to 3 weeks, except when loading dose is used.