Related Subjects:
| Status Epilepticus (Epilepsy)
| Coma management
| Lorazepam
| Phenytoin
| Levetiracetam
| Epilepsy - General Management
| First Seizure
| Epilepsy in Pregnancy
| Febrile seizures
- phenobarbitone or phenobarbitone
Mode of action
- Phenobarbital is a long-acting barbiturate with hypnotic and anticonvulsant properties.
Indications/Dose
- Epilepsy (Not 1st line Specialist use): Phenobarbital 60-180 mg PO nocte
- Status epilepticus: (dilute 1 in 10 with water for injections) 10 mg/kg. Give IV at a rate of not more than 100 mg/minute; max dose is 1 g
Interactions
- Phenobarbital causes hepatic microsomal enzyme induction
- Breastfeeding is therefore not recommended.
Cautions
- Avoid CNS depressants including alcohol as this may lead to additive CNS depressant effect.
Contraindications
- Known hypersensitivity to barbiturates or any of the ingredients.
- Severe respiratory depression. Acute intermittent porphyria.
- Severe impairment of renal or hepatic function.
Side effects
- Megaloblastic anaemia (due to folate deficiency).
- Agranulocytosis, aplastic anaemia and macrocytic anaemia are rare
- Osteopenia, osteoporosis and fractures long-term therapy with phenobarbital.
- Osteomalacia, hypocalcaemia, Dupuytren's contracture
- Mental depression and confusion, cognitive impairment, behavioural disturbance.
- Paradoxical excitement, irritability and hyperexcitability may sometimes occur particularly in the elderly and children.
- Drowsiness and lethargy. Nystagmus, Ataxia and respiratory depression.
- Allergic skin reactions, toxic epidermal necrolysis extremely rare.
- Hepatitis and cholestasis have been associated with barbiturate administration.
References