Home Drug Guide Pentobarbital Sodium

Drug Guide

Generic Name

Pentobarbital Sodium

Brand Names Sodium Pentobarbital, Nembutal Sodium, Nembutal

Classification

Therapeutic: Sedative-Hypnotic, Anxiolytic, Anticonvulsant

Pharmacological: Barbiturate

FDA Approved Indications

  • Short-term treatment of insomnia
  • Sedation before procedures
  • Control of seizures in certain epilepsy syndromes

Mechanism of Action

Pentobarbital enhances the activity of GABA at GABA_A receptors, leading to increased chloride ion influx, hyperpolarization of neurons, and central nervous system depression.

Dosage and Administration

Adult: Dosage varies depending on indication; for sedation, typically 100-200 mg IV or IM; consult specific protocols.

Pediatric: Use with caution; dosing based on weight and clinical response.

Geriatric: Start at lower doses due to increased sensitivity; monitor closely.

Renal Impairment: Dosage adjustment may be necessary; consult clinical guidelines.

Hepatic Impairment: Use with caution; metabolism may be impaired, requiring dosage reduction.

Pharmacokinetics

Absorption: Well absorbed IM and IV.

Distribution: Widely distributed; crosses blood-brain barrier and placenta.

Metabolism: Metabolized in the liver, mainly by oxidation.

Excretion: Excreted in urine, mostly as inactive metabolites.

Half Life: 4-16 hours, depending on dose, patient age, and hepatic function.

Contraindications

  • Hypersensitivity to barbiturates
  • Respiratory depression
  • Porphyria

Precautions

  • Use with caution in pregnant women, lactating women, patients with history of substance abuse, hepatic or renal impairment, or respiratory conditions. Potential for dependence and abuse.

Adverse Reactions - Common

  • Drowsiness (Common)
  • Dizziness (Common)
  • Respiratory depression (Uncommon)

Adverse Reactions - Serious

  • Circulatory collapse (Rare)
  • Dependence and tolerance (Common)
  • Suicidal ideation (Rare)

Drug-Drug Interactions

  • Other CNS depressants (additive sedation or respiratory depression)
  • CNS-active medications (anticonvulsants, antidepressants)

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor vital signs, level of consciousness, respiratory function.

Diagnoses:

  • Risk for respiratory depression
  • Impaired sleep pattern

Implementation: Use the lowest effective dose; monitor patient response.

Evaluation: Assess effectiveness of sedation or seizure control, monitor for adverse reactions.

Patient/Family Teaching

  • Avoid alcohol and other CNS depressants.
  • Do not operate heavy machinery or drive.
  • Report any excessive drowsiness, confusion, or respiratory difficulties.

Special Considerations

Black Box Warnings:

  • Risk of respiratory depression, coma, and death when used improperly or in combination with other CNS depressants.

Genetic Factors: N/A

Lab Test Interference: N/A

Overdose Management

Signs/Symptoms: Marked drowsiness, respiratory depression, coma, hypotension.

Treatment: Supportive care: maintain airway and breathing, activated charcoal if within 1 hour of ingestion, hemodialysis in severe cases, administer overdose-specific medications under medical supervision.

Storage and Handling

Storage: Store in a secure, locked cabinet at room temperature, away from light and moisture.

Stability: Stable under proper storage conditions for the shelf life specified by the manufacturer.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.