Phenobarbital (Luminal) #

Question 1

Class / Action

Answer 1

Barbiturate, anticonvulsant, sedative, hypnotic / Limits spread of seizure activity by increasing threshold for motor cortex activity; Sedative & hypnotic effects are due primarily to interference with impulse transmission of the cerebral cortex by inhibition of the reticular activating system.

Question 2

Onset / Duration of Action

Answer 2

3-30min / 4-6hrs

Question 3

Indications

Answer 3

1. Seizures
2. Anxiety

Question 4

Contraindications

Answer 4

1. Hypersensitivity
2. Patients with porphyria*
3. Severe liver or respiratory disease

Question 5

Precautions

Answer 5

1. Other anticonvulsants, CNS depressants, & MAO inhibitors may potentiate effects
2. Use with caution in pts with pulmonary, cardiovascular, hepatic, or renal insufficiency
3. Use a large, stable vein for injections (extraversion may cause tissue necrosis)
4. Monitor vital signs closely & prepare to assist with ventilations as necessary

Question 6

Dosage / Administration

Answer 6

1. Seizures:
   ADULT: 260mg SIVP, may repeat in 5min if seizure has Not stopped, may repeat a third dose in 5min if seizure has not stopped. Contact Base Station Thereafter.
   PEDS: 20mg/kg load dose SIVP over 10-15min
   CHILD <60kg: MAX rate of infusion 30mg/min
   CHILD >60kg: MAX rate of infusion 50mg/min
   Can be given in 10mg/kg increments
2. RSI:
   ADULT: 130mg SIVP
   PEDS: Contact Mary Bridge
3. Sedation:
   ADULT: 65mg SIVP. Contact Base Station Thereafter.
   PEDS: Contact Mary Bridge

Question 7

Adverse Reactions

Answer 7

1. CNS Depression
2. HypOtension
3. Bradycardia
4. Respiratory Depression
5. Nystagmus
6. Nausea & Vomiting