Phenobarbital
Medication of the barbiturate type / From Wikipedia, the free encyclopedia
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Phenobarbital, also known as phenobarbitone or phenobarb, sold under the brand name Luminal among others, is a medication of the barbiturate type.[4] It is recommended by the World Health Organization (WHO) for the treatment of certain types of epilepsy in developing countries.[6] In the developed world, it is commonly used to treat seizures in young children,[7] while other medications are generally used in older children and adults.[8] In developed countries it is used for veterinary purposes.[9] It may be used intravenously, injected into a muscle, or taken by mouth.[4] The injectable form may be used to treat status epilepticus.[4] Phenobarbital is occasionally used to treat trouble sleeping, anxiety, and drug withdrawal and to help with surgery.[4] It usually begins working within five minutes when used intravenously and half an hour when administered by mouth.[4] Its effects last for between four hours and two days.[4][5]
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Trade names | Luminal, Sezaby |
AHFS/Drugs.com | Monograph |
MedlinePlus | a682007 |
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Dependence liability | Low[1] |
Routes of administration | By mouth, rectal, parenteral |
Drug class | Barbiturate |
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Bioavailability | >95% |
Protein binding | 20 to 45% |
Metabolism | Liver (mostly CYP2C19) |
Onset of action | within 5 min (IV) and 30 min (PO)[4] |
Elimination half-life | 53 to 118 hours |
Duration of action | 4 hrs[4] to 2 days[5] |
Excretion | Kidney and fecal |
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ECHA InfoCard | 100.000.007 |
Chemical and physical data | |
Formula | C12H12N2O3 |
Molar mass | 232.239 g·mol−1 |
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Side effects include a decreased level of consciousness along with a decreased effort to breathe.[4] There is concern about both abuse and withdrawal following long-term use.[4] It may also increase the risk of suicide.[4] It is pregnancy category B or D (depending on how it is taken) in the United States and category D in Australia, meaning that it may cause harm when taken by pregnant women.[4][10] If used during breastfeeding it may result in drowsiness in the baby.[11] A lower dose is recommended in those with poor liver or kidney function, as well as elderly people.[4] Phenobarbital, like other barbiturates works by increasing the activity of the inhibitory neurotransmitter GABA.[4]
Phenobarbital was discovered in 1912 and is the oldest still commonly used anti-seizure medication.[12][13] It is on the World Health Organization's List of Essential Medicines.[14]