Home Drug Guide Secobarbital Sodium

Drug Guide

Generic Name

Secobarbital Sodium

Brand Names Seconal Sodium

Classification

Therapeutic: Sedative-Hypnotic

Pharmacological: Barbiturate

FDA Approved Indications

  • Short-term treatment of insomnia
  • Sedation prior to medical procedures

Mechanism of Action

Secobarbital binds to GABA-A receptors, enhancing the inhibitory effects of gamma-aminobutyric acid (GABA), leading to sedative, hypnotic, and anticonvulsant effects.

Dosage and Administration

Adult: Typically 100-200 mg at bedtime; dosage adjusted based on response and tolerability.

Pediatric: Not generally recommended due to safety concerns.

Geriatric: Start at lower end of dosing range, monitor closely for adverse effects.

Renal Impairment: Use with caution; dosage adjustments may be necessary.

Hepatic Impairment: Use with caution; monitor for increased sedation.

Pharmacokinetics

Absorption: Rapid absorption from the gastrointestinal tract.

Distribution: Widely distributed, crosses the blood-brain barrier.

Metabolism: Metabolized in the liver, primarily via hydroxylation and conjugation.

Excretion: Excreted mainly in the urine as metabolites.

Half Life: Approximately 15-48 hours, varies with dose and frequency.

Contraindications

  • History of porphyria, respiratory depression, or hypersensitivity to barbiturates.

Precautions

  • Use with caution in patients with a history of substance abuse, elderly, pregnancy, and in those with hepatic or renal impairment. Avoid abrupt discontinuation to prevent withdrawal symptoms.
  • Pregnancy category D: risk to fetus; use only if benefits outweigh risks.

Adverse Reactions - Common

  • Drowsiness (Common)
  • Dizziness (Common)
  • Memory impairment (Common)

Adverse Reactions - Serious

  • Respiratory depression (Less common but serious)
  • Dependence and addiction (Serious)
  • Potential for overdose leading to coma or death (Serious)

Drug-Drug Interactions

  • Other CNS depressants (e.g., alcohol, benzodiazepines, opioids) increase sedation and respiratory depression risk.
  • CYP450 enzyme inducers (e.g., rifampin) may decrease effectiveness.

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor for signs of CNS depression, respiratory depression, and dependence.

Diagnoses:

  • Risk for sedation, Fall risk, Risk for dependence.

Implementation: Administer at bedtime; avoid alcohol and other CNS depressants; monitor patient response.

Evaluation: Assess sleep quality, monitor for adverse effects, and signs of dependence.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Do not combine with alcohol or other CNS depressants.
  • Warn about daytime drowsiness and impaired coordination.
  • Do not abruptly stop medication; consult provider for tapering plan.

Special Considerations

Black Box Warnings:

  • Potential for serious respiratory depression and dependence.
  • Use with caution in elderly due to increased sensitivity and risk of falls.

Genetic Factors: None specifically identified.

Lab Test Interference: May affect liver function tests or other hepatic enzymes.

Overdose Management

Signs/Symptoms: Profound sedation, respiratory depression, coma, pinpoint pupils.

Treatment: Supportive care including airway management, supporting ventilation, activated charcoal if recent ingestion, and gastric lavage as appropriate. No specific antidote; consider use of barbiturate-specific rescue medications if available.

Storage and Handling

Storage: Store in a tight, light-resistant container at room temperature.

Stability: Stable under recommended storage conditions.

🛡️ 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.