MASSACHUSETTS GENERAL HOSPITAL

Department of Pharmacy

Department of Nursing

Critical Care

Generic Name: Phenobarbital
Trade Name:  
Action: - Reduction of monosynaptic and polysynpatic transmission resulting in decreased excitability of the nerve cell

- Increases threshold of electrical stimulation in the cerebral cortex

Indications: Tonic-clonic seizures
Partial seizures
Status epilepticus refractory to diazepam
Sedation
Administration Guidelines:
Usual Dose and Route: LOAD: 10 to 15 mg / kg IVP at 60 mg / min in acute convulsive disorders

Maintenance: 60 mg T.I.D. titrated to patient response and serum drug level

Standard Concentration: N / A
Special Considerations: - Burning sensation may result at site of injection if administered through peripheral access. Flush with 0.9% NaCl pre- and post-administration.

- Dosage adjustments may be required in:

geriatric patients

renal failure

hepatic failure

- Cumulative effect may be observed, dosage adjustment may be required

- Caution: will potentiate actions and side effects of narcotics and other CNS depressants

- Administration of full loading dose often requires intubation

Precautions and side effects: - For extravasation, refer to MGH Nursing procedure manual

- Hypotension

- Bradycardia

- Respiratory depression

 

revised 09/03