Drug Name Dosage & Route Action Indication Adverse Effects Contraindication Nursing Responsibility

Body as a Whole:
PHENOBARBITAL Anticonvulsant Long-acting barbiturate. Long-term management of Sensitivity to barbiturates; Assessment & Drug Effects
Myalgia, neuralgia, CNS
SODIUM Adult: PO 100–300 Sedative and hypnotic effects tonic-clonic (grand mal) manifest hepatic or familial
depression, coma, and death.
mg/d IV/IM 200–600 of barbiturates appear to be seizures and partial seizures; history of porphyria; severe
CNS: Somnolence, • Observe patients receiving large
mg up to 20 mg/kg due primarily to interference status epilepticus, eclampsia, respiratory or kidney disease;
Luminal Sodium nightmares, insomnia, doses closely for at least 30 min to
Child: PO/IV 3–8 with impulse transmission of febrile convulsions in young history of previous addiction
"hangover," headache, ensure that sedation is not excessive.
mg/kg or 125 mg/m2/d cerebral cortex by inhibition children. Also used as a to sedative hypnotics;
anxiety, thinking
Classifications: CENTRAL Neonate: PO/IV 3–4 of reticular activating system. sedative in anxiety or tension
abnormalities, dizziness,
uncontrolled pain; pregnancy • Keep patient under constant
NERVOUS SYSTEM mg/kg/d (max: 5 CNS depression may range states; in pediatrics as (particularly early pregnancy) observation when drug is
nystagmus, irritability,
AGENT; mg/kg/d) from mild sedation to coma, preoperative and (category D), lactation; administered IV, and record vital
paradoxic excitement and
ANTICONVULSANT; depending on dosage, route of postoperative sedation and to sustained release formulation signs at least every hour or more
exacerbation of hyperkinetic
SEDATIVE-HYPNOTIC; Status administration, degree of treat pylorospasm in infants. for children <12 y of age. often if indicated.
behavior (in children);
BARBITURATE Epilepticus nervous system excitability,
Adult/Child: IV 15–18 and drug tolerance. Initially,
confusion or depression or • Lab tests: Obtain liver function
marked excitement (older and hematology tests and
mg/kg in single or barbiturates suppress REM
adult or debilitated patients); determinations of serum folate and
divided doses (max: sleep, but with chronic
ataxia. CV: Bradycardia, vitamin D levels during prolonged
20 mg/kg) therapy REM sleep returns to
syncope, hypotension. GI: therapy.
Neonate: IV 15–20 normal.
Nausea, vomiting, • Monitor serum drug levels.
mg/kg in single or
constipation, diarrhea, Serum concentrations >50 mcg/mL
divided doses
epigastric pain, liver damage. may cause coma. Therapeutic serum
Hematologic: concentrations of 15–40 mcg/mL
Sedative
Megaloblastic anemia, produce anticonvulsant activity in
Adult: PO 30–120
agranulocytosis, most patients. These values are
mg/d IV/IM 100–200
thrombocytopenia. usually attained after 2 or 3 wk of
mg/d
Metabolic: Hypocalcemia, therapy with a dose of 100–200
Child: PO 6 mg/kg/d
osteomalacia, rickets. mg/d.
or 180 mg/m2 in 3
Musculoskeletal: Folic
divided doses IV/IM
acid deficiency, vitamin D • Expect barbiturates to produce
16–100 mg/d (1–3 restlessness when given to patients
deficiency. Respiratory:
mg/kg) in pain because these drugs do not
Respiratory depression. Skin:
Mild maculopapular, have analgesic action.
morbilliform rash; erythema • Be prepared for paradoxical
multiforme, Stevens-Johnson responses and report promptly in
syndrome, exfoliative older adult or debilitated patient and
dermatitis (rare). . children (i.e., irritability, marked
excitement [inappropriate
tearfulness and aggression in
children], depression, and
confusion).