Home Drug Guide Butabarbital Sodium

Drug Guide

Generic Name

Butabarbital Sodium

Brand Names Butisol Sodium, Sarisol No. 1, Sarisol No. 2, Sarisol, Buticaps, Butabarbital, Butabarb, Butalan

Classification

Therapeutic: Sedative and hypnotic for short-term use

Pharmacological: Barbiturate

FDA Approved Indications

Short-term treatment of insomnia
Preoperative sedation

Mechanism of Action

Butabarbital enhances the activity of gamma-aminobutyric acid (GABA) at GABA-A receptor sites, leading to sedative, hypnotic, and anxiolytic effects.

Dosage and Administration

Adult: Typically 50-100 mg at bedtime; maximum dose varies by physician discretion.

Pediatric: Use is generally not recommended in children due to safety concerns.

Geriatric: Dose adjustments may be necessary; start low and titrate carefully, considering increased sensitivity to sedatives.

Renal Impairment: Use with caution; adjustments may be needed based on renal function.

Hepatic Impairment: Use with caution; hepatic metabolism may be affected and increase sedation.

Pharmacokinetics

Absorption: Well absorbed orally.

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

Metabolism: Hepatic metabolism via hepatic enzymes.

Excretion: Renal excretion of metabolites.

Half Life: Approximately 100-250 hours, varies with individual and duration of use.

Contraindications

Allergy to barbiturates
Porphyria

Precautions

History of substance abuse
Respiratory depression
Hepatic impairment
Renal impairment
Use with caution in elderly and debilitated patients

Adverse Reactions - Common

Drowsiness (Common)
Dizziness (Common)
Headache (Sometimes)

Adverse Reactions - Serious

Respiratory depression (Rare)
Hypersensitivity reactions (Rare)
Addiction potential and tolerance (Significant with prolonged use)

Drug-Drug Interactions

Other CNS depressants (opioids, benzodiazepines)
Alcohol
Cimetidine
MAOIs

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor respiratory status, level of consciousness, and liver/renal function.

Diagnoses:

Risk for injury due to sedation or dizziness
Ineffective airway clearance

Implementation: Administer dose as prescribed; monitor for adverse effects; educate patient about sedation risks.

Evaluation: Assess effectiveness in improving sleep or sedation needs, monitor for adverse effects.

Patient/Family Teaching

Take medication exactly as prescribed.
Avoid alcohol and other CNS depressants.
Warn about potential drowsiness and impaired ability to perform tasks requiring alertness.
Do not stop abruptly after long-term use—doctors should advise on tapering.

Special Considerations

Black Box Warnings:

Potential for addiction, physical and psychological dependence

Genetic Factors: Genetic variations in enzyme metabolism may affect drug levels.

Lab Test Interference: None noted.

Overdose Management

Signs/Symptoms: Respiratory depression, coma, pinpoint pupils, hypotension, decreased reflexes.

Treatment: Supportive care including airway management, oxygen, IV fluids, gastric lavage, activated charcoal if recent ingestion; reversal with possibly **flumazenil** is ineffective in barbiturate overdose.

Storage and Handling

Storage: Store at room temperature, away from light and moisture.

Stability: Stable under recommended conditions.