Phenobarbital (Phenobarbital) / Luminal

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Therapeutic Class

• Schedule IV controlled substance

• Long-acting barbiturate

• GABA-A receptor agonist

Primary Medical Uses

✔ Seizure Control – First-line for epilepsy & acute convulsions
✔ Sedative/Hypnotic – Short-term insomnia treatment
✔ Neonatal Therapy – Jaundice management in newborns
✔ Alcohol Withdrawal – Delirium tremens prevention

Dosage Forms & Strengths

• Tablets: 15mg, 30mg, 60mg, 100mg

• Elixir: 20mg/5mL

• Injectable: 65mg/mL, 130mg/mL

Key Pharmacological Features

• Onset: 30-60 minutes (oral)

• Duration: 10-12 hours

• Half-life: 80-120 hours (adults)

• Metabolism: Hepatic (CYP450 system)

Dosing Guidelines

For Seizures (Adults):

• Loading: 10-20mg/kg

• Maintenance: 1-5mg/kg/day

For Insomnia:

• 100-320mg at bedtime

Critical Safety Information

 Black Box Warning:

• High abuse potential

• Severe withdrawal syndrome

• Life-threatening respiratory depression

Common Side Effects:

• Drowsiness

• Ataxia

• Cognitive impairment

• Paradoxical excitement (elderly)

Drug Interactions

Absolute Contraindications:

• MAO inhibitors

• Other CNS depressants

• Alcohol

Patient Counseling Points

• Avoid driving/operating machinery

• Do not discontinue abruptly

• Report any mood changes

• Store securely away from others

Prescribing Considerations

• DEA Schedule: IV

• Pregnancy Category: D

• Breastfeeding: Not recommended

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