Home Drug Guide Phenobarbital Sodium

Drug Guide

Generic Name

Phenobarbital Sodium

Brand Names Sezaby

Classification

Therapeutic: Anticonvulsant, Barbiturate

Pharmacological: GABA_A receptor modulator

FDA Approved Indications

  • Treatment of seizures, including partial and generalized seizures

Mechanism of Action

Enhances the activity of GABA at GABA_A receptors, increasing chloride ion influx and hyperpolarization of neurons, thereby reducing neuronal excitability.

Dosage and Administration

Adult: Initial dose varies based on condition; typically 30-120 mg/day in divided doses, titrated to response.

Pediatric: Dosing individualized based on weight and age; typically 1-5 mg/kg/day, divided doses.

Geriatric: Start at lower doses due to increased sensitivity; titrate carefully.

Renal Impairment: Adjust dosage accordingly; monitoring required.

Hepatic Impairment: Use with caution; monitor liver function; dosage adjustments may be necessary.

Pharmacokinetics

Absorption: Well absorbed after oral administration.

Distribution: Widely distributed in body tissues; crosses blood-brain barrier.

Metabolism: Primarily hepatic via hydroxylation and conjugation.

Excretion: Renal excretion of unchanged drug and metabolites.

Half Life: Approximately 53-118 hours, variable depending on individual factors.

Contraindications

  • History of hypersensitivity to barbiturates
  • Porphyria

Precautions

  • Respiratory depression, hepatocellular disease, history of addiction, risk of dependence, withdrawal hazards

Adverse Reactions - Common

  • Sedation, drowsiness (Common)
  • Dizziness (Common)
  • Cognitive impairment (Common)

Adverse Reactions - Serious

  • Respiratory depression (Rare)
  • Agranulocytosis, aplastic anemia (Rare)
  • Severe allergic reactions (anaphylaxis, angioedema) (Rare)

Drug-Drug Interactions

  • Other CNS depressants, leading to enhanced sedation or respiratory depression; Phenytoin, carbamazepine (altered metabolism); Warfarin (altered anticoagulant effect)

Drug-Food Interactions

  • Alcohol may enhance CNS depressant effects.

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Assess seizure control, respiratory status, sedation level, liver function.

Diagnoses:

  • Risk for injury related to sedation or dizziness
  • Impaired airway clearance

Implementation: Administer as prescribed; monitor vital signs and level of consciousness; educate about dependency.

Evaluation: Monitor seizure frequency and side effects for efficacy and safety.

Patient/Family Teaching

  • Do not discontinue abruptly to avoid withdrawal seizures.
  • Avoid alcohol and CNS depressants.
  • Report signs of hypersensitivity, unusual bleeding, or severe side effects.

Special Considerations

Black Box Warnings:

  • Dependence and withdrawal symptoms if discontinued abruptly.
  • Potential for respiratory depression.

Genetic Factors: None specifically noted for phenobarbital.

Lab Test Interference: May affect liver function tests and drug levels.

Overdose Management

Signs/Symptoms: Respiratory depression, extreme sedation, coma, hypotension, ataxia.

Treatment: Supportive care, airway management, activated charcoal if recent ingestion, possibly hemodialysis for severe cases.

Storage and Handling

Storage: Store at room temperature, 20-25°C (68-77°F), away from moisture and light.

Stability: Stable when stored properly.

🛡️ 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.