Drug reference

Pentobarbital

Sedative-Hypnotic · Sedative-Hypnotic, Anticonvulsant

Also known as NEMBUTAL, Nembutal Sodium injection

Sedative-HypnoticSedative-Hypnotic, Anticonvulsant

CDSCO approvedSchedule H

EXCRETION

—

not curated

INTERACTIONS

12 major

SEVERE in our sources

PREGNANCY

—

not curated

Top interactionssee all 12 →

AlfentanilSevereDatabaseDDInter
AnisindioneSevereDatabaseDDInter
BenzhydrocodoneSevereDatabaseDDInter
BuprenorphineSevereDatabaseDDInter

Mechanism

Pentobarbital is an intermediate-acting barbiturate that binds to an allosteric site on the GABA-A receptor complex distinct from the benzodiazepine binding site, increasing the duration of chloride channel opening in response to GABA. At higher concentrations, it can directly activate the chloride channel independently of GABA (GABA-mimetic effect), producing deeper CNS depression than benzodiazepines can achieve. Its intermediate duration of action (3-6 hours) reflects moderate lipophilicity enabling both redistribution from brain to peripheral tissues and hepatic oxidative metabolism.

Indications

InsomniaPre-operative sedationEmergency management of seizuresStatus epilepticusPreoperative and procedural sedation

Dosing

Adult: simple passive diffusion. If the goal is to accelerate excretion of the drug (eg, in a case of drug overdose), it is important to prevent its reabsorption from the tubule. This can often be accomplished by adjusting urine pH to make certain that most of the drug is in the ionized state, as shown in Figure 1–5. As a result of this partitioning effect, the drug is “trapped” in the urine.…