| SECOBARBITAL SODIUM
Classifications: sedative-hypnotic; barbiturate; anxiolytic; Therapeutic: sedative-hypnotic
Pregnancy Category: D
Controlled Substance: Schedule II
50 mg, 100 mg capsules
Short-acting barbiturate with CNS depressant effects as well as mood alteration from excitation to mild sedation, hypnosis,
and deep coma. Depresses the sensory cortex, decreases motor activity, alters cerebellar function and produces drowsiness,
sedation, and hypnosis.
Alters cerebellar function and produces drowsiness, sedation, and hypnosis.
Hypnotic for simple insomnia and preoperatively to provide basal hypnosis for general, spinal, or regional anesthesia.
History of sensitivity to barbiturates; porphyria; severe liver function; renal function impairment; severe respiratory
disease; nephritic syndrome; parturition, fetal immaturity; uncontrolled pain. Use of sterile injection containing polyethylene
glycol vehicle in patients with renal insufficiency; pregnancy (category D); children <6 y.
Pregnant women with toxemia or history of bleeding; labor and delivery; seizure disorders; aspirin hypersensitivity; liver
function impairment; hyperthyroidism; diabetes mellitus; severe anemia; older adults, debilitated individuals.
Route & Dosage
Adult: PO 100300 mg/d in 3 divided doses
Child: PO 46 mg/kg/d in 3 divided doses
Adult: PO 100300 mg 12 h before surgery
Child: PO 50100 mg 12 h before surgery
Adult: PO 100200 mg
- Give hypnotic dose only after patient retires for the evening.
- Crush and mix with a fluid or with food if patient cannot swallow pill.
Adverse Effects (≥1%)CNS:
Drowsiness, lethargy, hangover, paradoxical excitement in older adults. Respiratory: Respiratory depression, laryngospasm.
antagonizes effects of secobarbital; cns depressants
, alcohol, sedatives
depression; mao inhibitors
cause excessive CNS
increases risk of nephrotoxicity. Herbal: Kava, valerian
may potentiate sedation.
90% from GI tract. Onset:
1530 min. Duration:
14 h. Distribution:
Crosses placenta; distributed into breast milk. Metabolism:
In liver. Elimination:
In urine. Half-Life:
Assessment & Drug Effects
- Be alert to unexpected responses and report promptly. Older adults or debilitated patients and children sometimes have paradoxical
response to barbiturate therapy (i.e., irritability, marked excitement as inappropriate tearfulness and aggression in children,
depression, and confusion). Protect older adult patients from falling, irrational behavior, and effects of depression (anorexia,
- Patient may become irritable, and uncooperative after a subhypnotic dose of a short-acting barbiturate (uncommon response).
- Be aware that barbiturates do not have analgesic action, and may produce restlessness when given to patients in pain.
- Long-term therapy may result in nutritional folate (B9) and vitamin D deficiency.
- Lab tests: Obtain liver function and hematology tests, serum folate and vitamin D levels during prolonged therapy.
- Observe closely for changes in established drug regimen effectiveness whenever a barbiturate is added, at least during early
phase of barbiturate use. Barbiturates increase the metabolism of many drugs, leading to decreased pharmacologic effects
of those drugs.
- Be alert for acute toxicity (intoxication) characterized by profound CNS depression, respiratory depression that may progress
to Cheyne-Stokes respirations, hypoventilation, cyanosis, cold clammy skin, hypothermia, constricted pupils (but may be
dilated in severe intoxication), shock, oliguria, tachycardia, hypotension, respiration arrest, circulatory collapse, and
Patient & Family Education
- Do not drive or engage in potentially hazardous activities until response to drug is established.
- Store barbiturates in a safe place; not on the bedside table or other readily accessible places. It is possible to forget
having taken the drug, and in half-wakened conditions take more and accidentally overdose.
- Barbiturates are reportedly teratogenic. Do not become pregnant. Use or add barrier contraception if using hormonal contraceptives.
- Report onset of fever, sore throat or mouth, malaise, easy bruising or bleeding, petechiae, jaundice, rash to physician
during prolonged therapy.
- Do not consume alcohol in any amount when taking a barbiturate. It may severely impair judgment and abilities.