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Nembutal

Pentobarbital is a barbiturate that is available as both a free acid and a sodium salt, the former of which is only slightly soluble in water and ethanol. One trade name for this drug is Nembutal®, coined by Dr. John S. Lundy, who started using it in 1930, from the structural formula of the sodium salt—Na (sodium) + ethyl + methyl + butyl + al (common suffix for barbiturates). more...

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Uses

Approved

  • seizures
  • sedation

Unapproved/Investigational/Off-Label

  • reduction of intracranial pressure in Reye's syndrome, traumatic brain injury.
  • induction of coma in cerebral ischemia patients

Veterinary medicine

In veterinary medicine sodium pentobarbital—traded under names such as Sagatal—is used as an anaesthetic,.

Euthanasia

It is used by itself, or more often in combination with complementary agents such as phenytoin, in commercial euthanasia injectable solutions. Trade names include Euthasol, Euthatal, Beuthanasia-D and Fatal Plus.

Metabolism

Pentobarbital undergoes first-pass metabolism in the liver and possibly the intestines.

Drug Interactions

Administration of alcohol, opioids, antihistamines, other sedative-hypnotics, and other central nervous system depressants will additively increase the sedation caused by pentobarbital.

Tricyclic antidepressants decrease serum levels of pentobarbital.

References and End Notes

  • DBGET Result: COMPOUND: C07422
  • Davis's Drug Guide for Nurses, Eighth Edition Copyright © 2005 by F.A. Davis Company
  1. ^  "Pentobarbital." San Diego Reference Laboratory: Technical Help.
  2. ^  Lee C. Fosburgh (1997). Imagining in Time: From this point in time: Some memories of my part in the history of anesthesia -- John S. Lundy, MD. American Association of Nurse Anesthetists Journal 65 (4): 323-8. PMID 9281913 AANA Archives-Library page List of Library Holdings Worldwide
  3. ^  Unknown. ANESTHESIA AND ANALGESIA. Animal Use Protocols. University of Virginia. URL accessed on 4 October 2005.
  4. ^  UBC Committee on Animal Care. Euthanasia. SOP 009E1 - euthanasia - overdose with pentobarbital. The University of British Columbia. URL accessed on 4 October 2005.
  5. ^  Knodell RG, Spector MH, Brooks DA, Keller FX, Kyner WT. "Alterations in pentobarbital pharmacokinetics in response to parenteral and enteral alimentation in the rat." Gastroenterology. 1980 Dec;79(6):1211-6. PMID 6777235


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11 prescription drugs to be avoided by elderly
From Healthfacts, 7/1/05

In a study entitled, "Potentially Inappropriate Medication Use in Community-Dwelling Elderly," Chunliu Zhan, MD, PhD, and colleagues identified the following 11 drugs that should be avoided by people over the age of 65 years because the risk of adverse reactions greatly outweighs any benefit. (JAMA, 12/12/01).

The tranquilizer/hypnotic class of drugs called barbiturates (some brand names: Phenobarbital, Butisol, Luminal, Nembutal), which are often inappropriately prescribed for anxiety and sleep disorders--numerous products combine a barbiturate with other drugs;

flurazepam (brand name: Dalmane), a tranquilizer;

meprobamate (brand names: Equanil, Miltown), for occasional anxiety;

pentazocine (some brand names: Talacen, Talwin), a strong painkiller, which is a controlled substance;

trimethobenzamide (brand name: Tigan), for nausea and vomiting;

belladonna alkaloids (some brand names: Anaspaz, Cantil) to relieve cramps or spasms of the stomach, intestines, and bladder;

dicyclomine (brand name: Bentyl), for irritable bowel syndrome;

hyoscyamine (brand names: Levsin, Levbid), for disorders of the gastrointestinal tract;

and propantheline (brand name: Pro-Banthine), which is often combined with other medications to treat ulcers.

In Worst Pills, Best Pills, which has a much longer list of drugs to be avoided, the authors explain why older adults are more likely to suffer adverse drug reactions than younger adults. Some examples include smaller body size, different body composition (less water, more fat), decreased ability of the kidneys to clear drugs out of the body and the decreased ability of the liver to process drugs.

COPYRIGHT 2005 Center for Medical Consumers, Inc.
COPYRIGHT 2005 Gale Group

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