section name header

Pronunciation

fee-noe-BAR-bi-tal

Classifications

Therapeutic Classification: anticonvulsants, sedative/hypnotics

Pharmacologic Classification: barbiturates

Indications

BEERS REMS


Action

  • Produces all levels of CNS depression.
  • Depresses the sensory cortex, decreases motor activity, and alters cerebellar function.
  • Inhibits transmission in the nervous system and raises the seizure threshold.
  • Capable of inducing (speeding up) enzymes in the liver that metabolize drugs, bilirubin, and other compounds.
Therapeutic effects:
  • Anticonvulsant activity.
  • Sedation.

Pharmacokinetics

Absorption: Absorption is slow but relatively complete (70–90%).

Distribution: Unknown.

Metabolism/Excretion: 75% metabolized by the liver, 25% excreted unchanged by the kidneys.

Half-Life: Neonates: 1.8–8.3 days; Infants: 0.8–5.5 days; Children: 1.5–3 days; Adults: 2–6 days.

Time/Action Profile

(sedation)
ROUTEONSETPEAKDURATION
PO30–60 minunknown>6 hr
IM, SUBQ10–30 minunknown4–6 hr
IV5 min30 min4–6 hr



Full anticonvulsant effects occur after 2–3 wk of chronic dosing unless a loading dose has been used.

Contraind./Precautions

Contraindicated in:

Use Cautiously in:

Adv. Reactions/Side Effects

CV:

IV

hypotension

Derm: photosensitivity, rash, urticaria

GI: constipation, diarrhea, nausea, vomiting

Local: phlebitis at IV site

MS: arthralgia, myalgia

Neuro: hangover, delirium, depression, drowsiness, excitation, lethargy, neuralgia, vertigo

Resp: respiratory depression,

IV

LARYNGOSPASM, bronchospasm

Misc: HYPERSENSITIVITY REACTIONS (INCLUDING ANGIOEDEMA AND SERUM SICKNESS), physical dependence, psychological dependence

Interactions

Drug-drug:

Drug-Natural Products:

Route/Dosage

Status Epilepticus

Maintenance Anticonvulsant

Sedation

Hypnotic

Hyperbilirubinemia

Availability

(Generic available)

Assessment

Lab Test Considerations:

Toxicity and Overdose:

Implementation

IV Administration:

Patient/Family Teaching

Evaluation/Desired Outcomes

US Brand Names

Luminal, Sezaby

Contr. Subst. Schedule

Schedule IV (C-IV)

Code

NDC Code