| Name: |
PHENOBARBITAL SODIUM |
| Classification: |
barbiturate; anticonvulsant
- sedative
- used to treat seizures that fail to respond to phenytoin
|
| Dose: |
- For Status Epilepticus:
- Loading Dose: 15 mg/kg IV
- Maintenance Dose: 15 mg/kg as daily single dose, or 1.5 mg/kg q 8 h
|
| Administration: |
IV direct:
- undiluted OR diluted to 10mL with D5W, NS, RL
IV Infusion:
in 50-100mL D5W, NS, RL
- maximum rate of administration 60mg/min
|
| Adverse Effects: |
- respiratory depression
- laryngospasm, bronchospasm, apnea especially if administered too rapidly
- hypotension; caution in patients with cardiovascular disease
- solution is very alkaline; extravasation may produce tissue necrosis and thrombophlebitis
- intra-arterial injection may cause severe pain with reactions ranging from transient pain to gangrene
- skin rashes
|
| Drug Interactions: |
- phenobarbital + beta adrenergic blockers (eg. propranolol) = decreased beta blocker effect
- phenobarbital + haloperidol = decreased haloperidol effect
- phenobarbital + meperidine = increased meperidine CNS depression (increased production of normeperidine)
- phenobarbital + theophylline = decreased theophylline effect
|
| Monitoring Therapy: |
- respiratory rate
- BP
- HR, ECG
- arterial blood pressure
- serum concentrations, therapeutic 65-170 uM/L (pre-dose), toxic >215 uM/L
- administration site
|
| CCTC Protocol: |
- May be administered IV direct or by IV infusion by an approved nurse in CCTC.
- Should be administered via a central line if possible.
|
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