Pentobarbital
Administration
- Type: Anticonvulsant, Barbiturate
- Routes of Administration: IV, IM
- Common Trade Names: Nembutal
Adult Dosing
- Procedural sedation: 150-200mg IM x1
- Onset 10-15min IM; duration 1-4h IM
- Barbiturate coma: 1-3mg/kg/h IV
- Start: 10-15mg/kg IV x1, then 1mg/kg/h IV
- Taper dose gradually to discontinue if long-term use
Pediatric Dosing
- Procedural sedation: 2-6mg/kg IM x1
- Max: 100mg/dose
- Onset: 10-15min IM, 1min IV; duration: 1-4h IM, 15min IV
- Barbiturate coma: 1-3mg/kg/h IV
- Start: 10-15mg/kg IV x1, then 1mg/kg/h IV
- Taper dose gradually to discontinue if long-term use
Special Populations
Renal Dosing
- Renal impairment: decrease start dose
Hepatic Dosing
- Hepatic impairment: decrease start dose
Contraindications
- Allergy to class/drug
- Depressed respiratory function
- Porphyria
- Avoid abrupt withdrawal (long-term use)
Adverse Reactions
Serious
- respiratory depression
- Stevens-Johnson syndrome
- angioedema
- lupus erythematosus
Common
- somnolence
- agitation
- confusion
- hyperkinesia
- ataxia
- CNS depression
Pharmacology
- Half-life: 15-50 hrs
- Metabolism: CYP450
- Excretion: Urine
Mechanism of Action
alters sensory cortex, cerebellar, and motor activities; produces sedation, hypnosis, and anesthesia
Comments
Indications by Condition
The following table is automatically generated from disease/condition pages across WikEM.
| Indication | Dose | Context | Route | Population |
|---|---|---|---|---|
| Elevated intracranial pressure | 10 mg/kg IV over 30 min, then 5 mg/kg/hr x3 hrs, then 1 mg/kg/hr | Barbiturate coma for refractory ICP | IV | Adult |
| Moderate-to-severe traumatic brain injury | 10 mg/kg IV over 30 min, then 5 mg/kg/hr x3 hrs, then 1 mg/kg/hr | Barbiturate coma for refractory ICP | IV | Adult |
| Traumatic intracerebral hemorrhage | 10 mg/kg IV over 30 min, then 5 mg/kg/hr x3 hrs, then 1 mg/kg/hr | Barbiturate coma for refractory ICP | IV | Adult |