Generic Name

Talbutal

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Classification

FDA Approved Indications

• Short-term treatment of insomnia
• Anesthesia induction in some settings

Mechanism of Action

Talbutal enhances the activity of gamma-aminobutyric acid (GABA) at GABA-A receptor sites, leading to increased chloride ion influx, hyperpolarization of neurons, and CNS depression.

Dosage and Administration

Adult: As prescribed, typically 50-100 mg at bedtime for insomnia; dosage varies based on clinical judgment.

Pediatric: Not generally recommended due to safety concerns.

Geriatric: Start at lower doses due to increased sensitivity to CNS depressants.

Renal Impairment: Adjust dosage with caution, monitor closely.

Hepatic Impairment: Caution; dose reduction may be necessary.

Pharmacokinetics

Absorption: Rapid absorption after oral administration.

Distribution: Widely distributed, crosses blood-brain barrier.

Metabolism: Metabolized in the liver, primarily via oxidation.

Excretion: Excreted in urine as metabolites.

Half Life: Approximately 2-4 hours.

Contraindications

• Hypersensitivity to barbiturates
• Porphyria

Precautions

• Respiratory depression
• History of substance abuse
• Pregnancy and lactation: Use only if clearly needed; neonatal sedation risk.

Adverse Reactions - Common

• Drowsiness (Common)
• Dizziness (Common)
• Impaired cognitive function (Common)

Adverse Reactions - Serious

• Respiratory depression (Serious)
• CNS depression leading to coma (Rare)
• Hypersensitivity reactions (Rare)

Drug-Drug Interactions

• Other CNS depressants (e.g., opioids, benzodiazepines)
• Anticoagulants
• Oral contraceptives

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Patient/Family Teaching

• Take medication exactly as prescribed.
• Avoid alcohol and operating heavy machinery.
• Report signs of excessive sedation or respiratory difficulties.

Special Considerations

Black Box Warnings:

• Potential for respiratory depression and dependence with long-term use.

Genetic Factors: Slow metabolizers may experience prolonged sedation.

Lab Test Interference: May interfere with certain liver function tests.

Overdose Management

Signs/Symptoms: Profound sedation, respiratory depression, coma, and hypotension.

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

Storage and Handling

Storage: Store in a tightly closed container at room temperature, away from moisture and light.

Stability: Stable under recommended conditions for the duration specified by the manufacturer.