Drug Data Generic Name phenobarbital Trade Name Ancalixir, Luminal, Solfoton Patients Dose
Classificatio n Therapeutic" Anticon$ul#an t#, Sedati$e# Pharmacolo gic %arbiturate# Pregnanc& Categor& D
Mechanism of Action &roduce# all le$el# of '(S depre##ion! )epre##e# the #en#ory cortex, decrea#e# motor acti$ity, and alter# cerebellar function! *nhibit# tran#mi##ion in the ner$ou# #y#tem and rai#e# the #ei+ure thre#hold! 'apable of inducing ,#peeding up- en+yme# in the li$er that metaboli+e drug#, bilirubin, and other compound#! Pharmaco)in etics A" Ab#orption i# #lo. but relati$ely complete ,/00 102-! D" 3n4no.n M*'" /52 metaboli+ed by the li$er, 252 excreted unchanged by the 4idney#! Onset &56 30" 0 min! *7,Subcu610"30min *865min Pea) &5,*7,Subcu6 un4no.n *86 30min! Duration &569 hr *7,Subcu, *86 :" hr Drug +alf ,ife (eonate#6 1!808!3 day#; *nfant#6 0!80
Indication General Indications Anticon$ul#ant in tonic"clonic ,grand mal-, partial, and febrile #ei+ure# in children! &reoperati$e #edati$e and in other #ituation# in .hich #edation may be re<uired! =ypnotic ,#hort"term-! Patients Actual Indication
Contraindications =yper#en#iti$ity; 'omato#e patient# or tho#e .ith pre" exi#ting '(S depre##ion; Se$ere re#piratory di#ea#e .ith dy#pnea or ob#truction; 3ncontrolled #e$ere pain; >no.n alcohol intolerance ,elixir only-; Lactation6 )i#continue drug or bottle feed! Precaution =epatic dy#function; Se$ere renal impairment; =i#tory of #uicide attempt or drug abu#e; =ypnotic u#e #hould be #hort"term! 'hronic u#e may lead to dependence; 5%6 'hronic u#e during pregnancy re#ult# in drug dependency in the infant; may re#ult in coagulation defect# and fetal malformation; acute u#e at term may re#ult in re#piratory depre##ion in the ne.born; ?eri6 *initial do#e reduction recommended; =ypnotic u#e #hould be #hort" term! 'hronic u#e may lead to dependence!
Adverse Reaction CN#" hango$er, delirium, depre##ion, dro.#ine##, excitation, lethargy, $ertigo! Resp" re#piratory depre##ion; IV, LA@A(?5S&AS7, broncho#pa#m! C!" IVB hypoten#ion! GI" con#tipation, diarrhea, nau#ea, $omiting! Derm" photo#en#iti$ity, ra#he#, urticaria! ,ocal" phlebiti# at *8 #ite! M#" arthralgia, myalgia, neuralgia! Misc" hyper#en#iti$ity reaction# including A(?*5C)C7A and SC@37 S*'>(CSS, phy#ical dependence, p#ychological dependence!
Nursing Responsibilities -efore 1! A##e# patientD# diagno#i#! 2! A##e## patientD# mental #tatu#! 3! Ea4e 8/S of patient! :! A##e## patientD# L5'! 5! 5btain pre#cribed do#e! During 1! 'onfirm patientD# identity! 2! Admini#ter medication at the right pre#cribed route! 3! )o not go o$er the recommended do#e! :! Super$i#e ambulation and tran#fer of patient# follo.ing admini#tration! 5! Eablet# may be cru#hed and mixed .ith food# or fluid# for patient# .ith difficulty #.allo.ing! After 1! 5b#er$e proper documentation of admini#tered medication! 2! Cn#ure that patient ha# fully #.allo.ed oral form of medication! 3! 5b#er$e patientD# beha$ior clo#ely for atlea#t 15"30
Minimum Dose PO I!" 1mg/day #ubcu$IM" 3mg/day Ma%imum Dose PO$I!$IM$ #ubcu" 320mg/day Contents phenobarbital Availabilit& and color Tablets" 8 mg, 15 mg, 30 mg, 0 mg, 100 mg! Capsules" 15 mg! 'li%ir" 20 mg/5 mL! In(ection" 30 mg/mL in 1" mL prefilled #yringe#, 0 mg/mL in 1" mL prefilled
#yringe#, 5 mg/mL in 1" mL $ial#, 130 mg/mL in 1" mL prefilled #yringe#, 1"mL $ial#, and 1" mL ampule#! Routes of administra tion *8,&5,Subcu,*7
5!5 day#; 'hildren6 1!503 day#; Adult#6 20 day#!
!Drug interaction .drug to drug Additi$e '(S depre##ion .ith other CN# depressants, including alcohol, antihistamines, opioid analgesics, and other sedative/ h&pnotics! 7ay induce hepatic en+yme# that metaboli+e other drug#,ptheir effecti$ene##, including hormonal contraceptives, 0arfarin, chloramphenicol, c&closporine, dacarba1ine, corticosteroids, tric&clic antidepressants, felodipine, clona1epam, carbama1epine, verapamil, theoph&lline, metronida1ole, and 2uinidine!
minute# after admini#tration! :! 7onitor patientD# 8/S throughout the therapy! 5! *n#truct patient to re#t to decrea#e ri#4 of fall#!
#ource" )eglin, F! et! Al! 2001! )a$i#D# )rug ?uide for (ur#e#! 12 th ed! G!A! )a$i#! pp 1015"101/
