BUTABARBITAL SODIUM
| BUTABARBITAL SODIUM (byoo-ta-bar'bi-tal) Butisol Sodium Classifications: barbiturate; anxiolytic; sedative-hypnotic; Therapeutic: antianxiety; sedative-hypnotic Prototype: Phenobarbital Pregnancy Category: C Controlled Substance: Schedule III |
Availability
30 mg, 50 mg tablets; 30 mg/5 mL elixir
Action
Intermediate-acting barbiturate that appears to act at thalamus level, where it interferes with transmission of impulses to the cerebral cortex.
Therapeutic Effect
Preoperative sedative agent that also is an effective antianxiety agent.
Uses
Hypnotic in short-term treatment of simple insomnia, as sedative for relief of anxiety, and to provide sedation preoperatively.
Contraindications
Porphyria; uncontrolled pain; severe respiratory disease; history of addiction; pregnancy (category C), lactation.
Cautious Use
Severe renal or hepatic impairment; acute abdominal conditions; head trauma, history of seizures; history of herpes infection; older adults or debilitated patients.
Route & Dosage
| Daytime Sedation Adult: PO 15–30 mg t.i.d. or q.i.d. Preoperative Sedation Adult: PO 50–100 mg 60–90 min before surgery Child: PO 2–6 mg/kg/dose (max: 100 mg) Hypnotic Adult: PO 50–100 mg h.s. |
Administration
Oral- Schedule slow withdrawal following long-term use to avoid precipitating withdrawal symptoms.
- Store in tightly covered containers, preferably at 15°–30° C (59°–86° F), unless otherwise directed.
Adverse Effects (≥1%)
CNS: Drowsiness, residual sedation ("hangover"), headache. GI: Nausea, vomiting, constipation, diarrhea. Skin: Urticaria, skin rash. Musculoskeletal: Muscle or joint pain.Interactions
Drug: Alcohol and other cns depressants add to CNS and respiratory depression; butabarbital increases the metabolism of oral anticoagulants, beta blockers, corticosteroids, doxycycline, griseofulvin, quinidine, theophyllines, oral contraceptives, decreasing their effectiveness. Herbal: Kava, valerian may potentiate sedation.Pharmacokinetics
Absorption: Readily from GI tract. Onset: 40–60 min. Peak: 3–4 h. Duration: 6–8 h. Distribution: Crosses placenta; distributed into breast milk. Metabolism: In liver. Elimination: In urine primarily as metabolites. Half-Life: Average 100 h.Nursing Implications
Assessment & Drug Effects
- Assess for adverse effects. Older adults and debilitated patients sometimes manifest excitement, confusion, or depression. Children also may react with paradoxical excitement. Side rails may be advisable. Report these reactions to physician.
Patient & Family Education
- Do not drive or engage in other potentially hazardous activities until response to drug is known.
- Do not drink alcoholic beverages while taking this drug. Other CNS depressants may produce additive drowsiness; do not take without approval of physician.
- Note: Prolonged use is not recommended because tolerance to drug occurs in about 14 d.
Common adverse effects in italic, life-threatening effects underlined; generic names in bold; classifications in SMALL CAPS; 
Canadian drug name; 
Prototype drug