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Encyclopedia > Phenobarbital
Phenobarbital
Systematic (IUPAC) name
5-ethyl-5-phenylpyrimidine-2,4,6(1H,3H,5H)-trione
Identifiers
CAS number 50-06-6
ATC code N05CA24 N03AA02
PubChem 4763
DrugBank APRD00184
Chemical data
Formula C12H12N2O3 
Mol. mass 232.235 g/mol
Pharmacokinetic data
Bioavailability >95%
Protein binding 20 to 45%
Metabolism Hepatic (mostly CYP2C19)
Half life 53 to 118 hours
Excretion Renal and fecal
Therapeutic considerations
Pregnancy cat.

D(US) Image File history File links Size of this preview: 533 × 600 pixelsFull resolution (1000 × 1125 pixel, file size: 66 KB, MIME type: image/png) File historyClick on a date/time to view the file as it appeared at that time. ... Image File history File links Size of this preview: 740 × 599 pixelsFull resolution (1010 × 818 pixel, file size: 144 KB, MIME type: image/png) Other versions Image:Phenobarbital3d. ... IUPAC nomenclature is a system of naming chemical compounds and of describing the science of chemistry in general. ... CAS registry numbers are unique numerical identifiers for chemical compounds, polymers, biological sequences, mixtures and alloys. ... The Anatomical Therapeutic Chemical Classification System is used for the classification of drugs. ... A section of the Anatomical Therapeutic Chemical Classification System. ... A section of the Anatomical Therapeutic Chemical Classification System. ... PubChem is a database of chemical molecules. ... The DrugBank database available at the University of Alberta is a unique bioinformatics and cheminformatics resource that combines detailed drug (i. ... A chemical formula is a concise way of expressing information about the atoms that constitute a particular chemical compound. ... For other uses, see Carbon (disambiguation). ... This article is about the chemistry of hydrogen. ... General Name, symbol, number nitrogen, N, 7 Chemical series nonmetals Group, period, block 15, 2, p Appearance colorless gas Standard atomic weight 14. ... This article is about the chemical element and its most stable form, or dioxygen. ... The molecular mass (abbreviated Mr) of a substance, formerly also called molecular weight and abbreviated as MW, is the mass of one molecule of that substance, relative to the unified atomic mass unit u (equal to 1/12 the mass of one atom of carbon-12). ... In pharmacology, bioavailability is used to describe the fraction of an administered dose of unchanged drug that reaches the systemic circulation, one of the principal pharmacokinetic properties of drugs. ... A drugs efficacy may be affected by the degree to which it binds to the proteins within blood plasma. ... Drug metabolism is the metabolism of drugs, their biochemical modification or degradation, usually through specialized enzymatic systems. ... The liver is the largest internal organ in the human body, and is an organ present in vertebrates and some other animals. ... Cytochrome P450 2C19 (abbreviated CYP2C19), a member of the cytochrome P450 mixed-function oxidase system, is involved in the metabolism of xenobiotics in the body. ... The biological half-life of a substance is the time required for half of that substance to be removed from an organism by either a physical or a chemical process. ... The kidneys are important excretory organs in vertebrates. ... The kidneys are the organs that filter wastes (such as urea) from the blood and excrete them, along with water, as urine. ... The pregnancy category of a pharmaceutical agent is an assessment of the risk of fetal injury due to the pharmaceutical, if it is used as directed by the mother during pregnancy. ... For other uses of terms redirecting here, see US (disambiguation), USA (disambiguation), and United States (disambiguation) Motto In God We Trust(since 1956) (From Many, One; Latin, traditional) Anthem The Star-Spangled Banner Capital Washington, D.C. Largest city New York City National language English (de facto)1 Demonym American...

Legal status

Class B(UK) Schedule IV(US) The regulation of therapeutic goods, that is drugs and therapeutic devices, varies by jurisdiction. ... The Misuse of Drugs Act 1971 is an Act of Parliament, by which the United Kingdom aims to control the possession and supply of numerous drugs and drug-like substances, as listed under the Act, and to enable international co-operation against illegal drug trafficking. ... This box:      The Controlled Substances Act (CSA) was enacted into law by the Congress of the United States as Title II of the Comprehensive Drug Abuse Prevention and Control Act of 1970. ... For other uses of terms redirecting here, see US (disambiguation), USA (disambiguation), and United States (disambiguation) Motto In God We Trust(since 1956) (From Many, One; Latin, traditional) Anthem The Star-Spangled Banner Capital Washington, D.C. Largest city New York City National language English (de facto)1 Demonym American...

Routes Oral, rectal, parenteral (intramuscular and intravenous)

Phenobarbital (INN) or phenobarbitone (former BAN) is a barbiturate, first marketed as Luminal by Friedr. Bayer et comp. It is the most widely used anticonvulsant worldwide and the oldest still in use. It also has sedative and hypnotic properties but, as with other barbiturates, has been superseded by the benzodiazepines for these indications. The World Health Organization recommends its use as first-line for partial and generalized tonic-clonic seizures (those formerly known as Grand Mal) in developing countries. It is a core medicine in the WHO Model List of Essential Medicines, which is a list of minimum medical needs for a basic health care system.[1] In more affluent countries it is no longer recommended as a first-line medication, however it is relied on as an alternate when a patient fails to respond to treatment with more modern AED's (Anti-Epileptic-Drugs).[2][3] It is still commonly used around the world to treat neonatal seizures.[4] In pharmacology and toxicology, a route of administration is the path by which a drug, fluid, poison or other substance is brought into contact with the body. ... Intramuscular injection is the injection of a substance directly into a muscle. ... Intravenous therapy or IV therapy is the giving of liquid substances directly into a vein. ... An International Nonproprietary Name (INN) is the official non-proprietary or generic name given to a pharmaceutical substance, as designated by the World Health Organization. ... A British Approved Name (BAN) is the official non-proprietary or generic name given to a pharmaceutical substance, as defined in the British Pharmacopoeia (BP). ... Barbituric acid, the basic structure of all barbiturates Barbiturates are drugs that act as central nervous system depressants, and by virtue of this they produce a wide spectrum of effects, from mild sedation to anesthesia. ... Luminal is another name for the hypnotic, anti-epileptic drug phenobarbital. ... Bayer AG (IPA pronunciation //) (ISIN: DE0005752000, NYSE: BAY, TYO: 4863 ) is a German chemical and pharmaceutical company founded in Barmen, Germany in 1863. ... The anticonvulsants, sometimes also called antiepileptics, belong to a diverse group of pharmaceuticals used in prevention of the occurrence of epileptic seizures. ... A sedative is a substance that depresses the central nervous system (CNS), resulting in calmness, relaxation, reduction of anxiety, sleepiness, and slowed breathing, as well as slurred speech, staggering gait, poor judgment, and slow, uncertain reflexes. ... Hypnotic drugs are a class of drugs that induce sleep, used in the treatment of severe insomnia. ... Alprazolam 2 mg tablets The benzodiazepines (pronounced , or benzos for short) are a class of psychoactive drugs considered minor tranquilizers with varying hypnotic, sedative, anxiolytic, anticonvulsant, muscle relaxant and amnesic properties, which are mediated by slowing down the central nervous system. ... WHO redirects here. ... Tonic-clonic seizures (also known as Grand Mal Seizures, though this term is now discouraged and rarely used in a clinical setting) are a type of generalised seizure affecting the whole brain. ... This article is about epileptic seizures. ...  Newly industrialized countries  Other emerging markets  Other developing economies  High income  Upper-middle income  Lower-middle income  Low income A developing country is that country which has a relatively low standard of living, an undeveloped industrial base, and a moderate to low Human Development Index (HDI) score and per capita... The World Health Organization (WHO) Model List of Essential Medicines is a guideline for national governments that want to ensure they have an inventory of medicines needed by every health system. ... A human infant The word Infant derives from the Latin in-fans, meaning unable to speak. ...

Contents

History

The first barbiturate drug, barbital, was synthesized in 1902 by German chemists Emil Fischer and Joseph von Mering at Bayer. By 1904 several related drugs, including phenobarbital, had been synthesized by Fischer. Phenobarbital was brought to market in 1912 by the drug company Bayer using the brand Luminal. It remained a commonly prescribed sedative and hypnotic until the introduction of benzodiazepines in the 1950s.[5] Barbital (marketed under the brand name Veronal), also called barbitone, was the first commercially marketed barbiturate. ... Hermann Emil Fischer (October 9, 1852 - July 15, 1919) was a German chemist and recipient of the Nobel Prize for Chemistry in 1902. ... Joseph, Baron von Mering (born February 28, 1849, in Cologne - died January 5, 1908, at Halle an der Saale, Germany) was a German physician. ...


Phenobarbital's soporific, sedative and hypnotic properties were well known in 1912, but nobody knew it was also an effective anticonvulsant. The young doctor Alfred Hauptmann[6] gave it to his epilepsy patients as a tranquiliser and discovered that their epileptic attacks were susceptible to the drug. Hauptmann performed a careful study of his patients over an extended period. Most of these patients were using the only effective drug then available, bromide, which had terrible side effects and limited efficacy. On phenobarbital, their epilepsy was much improved: the worst patients suffered fewer and lighter seizures and some patients became seizure free. In addition, they improved physically and mentally as bromides were removed from their regime. Patients who had been institutionalised due to the severity of their epilepsy were able to leave and, in some cases, resume employment. Hauptman dismissed concerns that its effectiveness in stalling epileptic attacks could lead to patients suffering a build-up that needed to be "discharged". As he expected, withdrawal of the drug lead to an increase in seizure frequency – it was not a cure. The drug was quickly adopted as the first widely effective anticonvulsant, though World War I delayed its introduction in the U.S.[7] Potassium bromide (KBr) is a salt, used as an anticonvulsant and a sedative in the 1800s. ... “The Great War ” redirects here. ...


Phenobarbital was used to treat neonatal jaundice by increasing liver metabolism and thus lowering bilirubin levels. In the 1950s, phototherapy was discovered, and became the standard treatment.[8] Jaundice, also known as icterus (adjective:Icteric), is yellowing of the skin, sclera (the white of the eyes) and mucous membranes caused by increased levels of bilirubin in the human body. ... Bilirubin is a yellow breakdown product of normal heme catabolism. ... Light therapy or phototherapy consists of exposure to specific ranges of light wavelengths (using lasers or LEDs), or very bright, full-spectrum light, for a prescribed amount of time. ...


In 1940, Winthrop Chemical produced sulfathiazole tablets that were contaminated with phenobarbital. This occurred because both tablets were produced side-by-side and equipment could be interchanged. Each antibacterial tablet contained more than twice the required dose of phenobarbital necessary to induce sleep. Hundreds of patients died or were injured as a result. A U.S. Food and Drug Administration investigation was highly critical of Winthrop and the scandal lead to the introduction of Good Manufacturing Practice for drugs.[8] Sulfathiazole is a short-acting sulfa drug. ... “FDA” redirects here. ... Good Manufacturing Practice or GMP (also referred to as cGMP or current Good Manufacturing Practice) is a term that is recognized worldwide for the control and management of manufacturing and quality control testing of foods and pharmaceutical products. ...


The drug itself through predated FDA approval processes and has failed to be formally cleared for use in subsequent years. Guidance was issued in June 2006 of plans to enforce US approval for unapproved drugs.[9]


Phenobarbital was used for over 25 years as prophylaxis in the treatment of febrile seizures.[10] Although an effective treatment in preventing recurrent febrile seizures, it had no positive effect on patient outcome or risk of developing epilepsy. The treatment of simple febrile seizures with anticonvulsant prophylaxis is no longer recommended.[11][12] Prophylaxis refers to any medical or public health procedure whose purpose is to prevent, rather than treat or cure, disease. ... A febrile seizure, also known as a fever fit or febrile convulsion is a generalized convulsion caused by elevated body temperature. ...


Indications

Phenobarbital is indicated in the treatment of all types of seizures except absence seizures.[2][13] Phenobarbital is no less effective at seizure control than more modern drugs such as phenytoin and carbamazepine. It is, however, significantly less well tolerated.[14][15] Absence seizures are one of several kinds of seizures. ... Phenytoin sodium (marketed as Dilantin® in the USA and as Epanutin® in the UK, by Parke-Davis, now part of Pfizer) is a commonly used antiepileptic. ... Carbamazepine (CBZ) is an anticonvulsant and mood stabilizing drug, used primarily in the treatment of epilepsy and bipolar disorder. ...


The first line drugs for treatment of status epilepticus are fast acting benzodiazepines such as diazepam or lorazepam. If these fail then phenytoin may be used, with phenobarbital being an alternative in the U.S. but used only third line in the UK.[16] Failing that, the only treatment is anaesthesia in intensive care.[13][17] Diazepam (IPA: ), first marketed as Valium by Hoffmann-La Roche) is a benzodiazepine derivative drug. ... Lorazepam is a benzodiazepine tranquilizer with short to medium duration of action. ... Phenytoin sodium (marketed as Dilantin® in the USA and as Epanutin® in the UK, by Parke-Davis, now part of Pfizer) is a commonly used antiepileptic. ... Anesthesia (AE), also anaesthesia (BE), is the process of blocking the perception of pain and other sensations. ... Intensive care medicine or critical care medicine is concerned with providing greater than ordinary medical care and observation to people in a critical or unstable condition. ...


Phenobarbital is the first line choice for the treatment of neonatal seizures.[4][18][19] Concerns that neonatal seizures in themselves could be harmful make most physicians treat them aggressively. There is, however, no reliable evidence to support this approach.[20] A human infant The word Infant derives from the Latin in-fans, meaning unable to speak. ...


Side effects

Sedation and hypnosis are the principal side effects of phenobarbital. Central nervous system effects like dizziness, nystagmus and ataxia are also common. In elderly patients, it may cause excitement and confusion while in children, it may result in paradoxical hyperactivity. A diagram showing the CNS: 1. ... Nystagmus is involuntary eye movement that can be part of the vestibulo-ocular reflex (VOR), with the eyes moving first in the direction of the lesioned side (slow phase) followed by a quick correction (fast phase) to the opposite side or away from the lesioned side. ... For other uses, see Ataxia (disambiguation). ...


Contraindications

Acute intermittent porphyria, oversensitivity for barbiturates, prior dependence on barbiturates, severe respiratory insufficiency and hyperkinesia in children. Acute intermittent porphyria (AIP) is a rare metabolic disorder that is characterized by a deficiency of the enzyme, porphobilinogen deaminase (PBG-D), also known as uroporphyrinogen I-synthase. ...


Overdose

Poisoning by barbiturates
Classification and external resources
ICD-10 T42.3
eMedicine med/207 

Phenobarbital causes a "depression" of the body's systems, mainly the central and peripheral nervous systems; thus, the main characteristic of phenobarbital overdose is a "slowing" of bodily functions, including decreased consciousness (even coma), bradycardia, bradypnea, hypothermia, and hypotension (in massive overdoses). Overdose may also lead to pulmonary edema and acute renal failure as a result of shock. The International Statistical Classification of Diseases and Related Health Problems (most commonly known by the abbreviation ICD) provides codes to classify diseases and a wide variety of signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or disease. ... The International Statistical Classification of Diseases and Related Health Problems 10th Revision (ICD-10) is a coding of diseases and signs, symptoms, abnormal findings, complaints, social circumstances and external causes of injury or diseases, as classified by the World Health Organization (WHO). ... // S00-T98 - Injury, poisoning and certain other consequences of external causes (S00-S09) Injuries to the head (S00) Superficial injury of head (S01) Open wound of head (S02) Fracture of skull and facial bones (S03) Dislocation, sprain and strain of joints and ligaments of head (S04) Injury of cranial nerves... eMedicine is an online clinical medical knowledge base that was founded in 1996. ... A diagram showing the CNS: 1. ... The Peripheral nervous system resides or extends outside the CNS central nervous system (the brain and spinal cord) to serve the limbs and organs. ... Consciousness is a quality of the mind generally regarded to comprise qualities such as subjectivity, self-awareness, sentience, sapience, and the ability to perceive the relationship between oneself and ones environment. ... For other uses, see Coma (disambiguation). ... Bradycardia, as applied to adult medicine, is defined as a resting heart rate of under 60 beats per minute, though it is seldom symptomatic until the rate drops below 50 beat/min. ... Bradypnea (Greek from bradys, slow + pnoia, breath), British English spelling bradypnoea refers to an abnormally slow breathing rate. ... Hypothermia is a condition in which an organisms temperature drops below that Required fOr normal metabolism and Bodily functionS. In warm-blooded animals, core [[body Temperature]] is maintained nEar a constant leVel through biologic [[homEostasis]]. But wheN the body iS exposed to cold Its internal mechanismS may be unable... In physiology and medicine, hypotension refers to an abnormally low blood pressure. ... Pulmonary edema is swelling and/or fluid accumulation in the lungs. ... This article is about the medical condition. ...


The electroencephalogram of a person with phenobarbital overdose may show a marked decrease in electrical activity, to the point of mimicking brain death. This is due to profound depression of the central nervous system, and is usually reversible.[21] Electroencephalography is the neurophysiologic exploration of the electrical activity of the brain by the application of electrodes to the scalp. ... Brain death is defined as a complete and irreversible cessation of brain activity. ...


Treatment of phenobarbital overdose is supportive, and consists mainly in the maintenance of airway patency (through endotracheal intubation and mechanical ventilation), correction of bradycardia and hypotension (with intravenous fluids and vasopressors, if necessary) and removal of as much drug as possible from the body. Depending on how much time has elapsed since ingestion of the drug, this may be accomplished through gastric lavage (stomach pumping) or use of activated charcoal. Hemodialysis is effective in removing phenobarbital from the body, and may reduce its half-life by up to 90%.[21] There is no specific antidote for barbiturate poisoning. The airways are those parts of the respiratory system through which air flows, to get from the external environment to the alveoli. ... Intubation being practiced on a dummy (conventional technique using a laryngoscope) In medicine, intubation is the placement of a tube into an external or internal orifice of the body. ... mechanical or forced ventilation is the use of powered equipment, e. ... Intravenous therapy or IV therapy is the giving of liquid substances directly into a vein. ... Vasopressor is a drug used to constrict the arteries and increase blood pressure. ... Gastric lavage, also commonly called a stomach pump, is the process of cleaning out the contents of the stomach. ... Activated carbon (also called activated charcoal) is the more general term which includes material mostly derived from charcoal. ... It has been suggested that Artificial kidney be merged into this article or section. ...


British veterinarian Donald Sinclair, better known as "Sigfried Farnon" in the "All Creatures Great and Small" books of James Herriot committed suicide at the age of 84 by injecting himself with an overdose of phenobarbital. Activist Abbie Hoffman also committed suicide by consuming phenobarbital, combined with alcohol, on April 12, 1989; the residue of around 150 pills was found in his body at autopsy.[22] Donald Sinclair (1910 - June 28, 1995) was a British veterinarian made famous as the eccentric character Siegried Farnon in the books by James Herriot. ... All Creatures Great and Small was the title given to a compilation volume first published in 1972 comprising James Herriots first two novels, If Only They Could Talk and It Shouldnt Happen to a Vet, which were considered too short to publish individually in the U.S. market. ... Herriot’s former surgery in Thirsk is now a tourist attraction. ... Abbott Howard Abbie Hoffman (November 30, 1936 – April 12, 1989) was a self-identified communo-anarchist,[1] social and political activist in the United States, co-founder of the Youth International Party (Yippies), and later, a fugitive from the law, who lived under an alias following a conviction for dealing...


Pharmacokinetics

Phenobarbital has an oral bioavailability of approximately 90%. Peak plasma concentrations are reached 8 to 12 hours after oral administration. It is one of the longest-acting barbiturates available – it remains in the body for a very long time (half-life of 2 to 7 days) and has very low protein binding (20 to 45%). Phenobarbital is metabolized by the liver, mainly through hydroxylation and glucuronidation, and induces most isozymes of the cytochrome P450 system. Cytochrome P450 2B6 System is more specifically induced by Phenobarbital. It is excreted primarily by the kidneys. In pharmacology, bioavailability is used to describe the fraction of an administered dose of unchanged drug that reaches the systemic circulation, one of the principal pharmacokinetic properties of drugs. ... A drugs efficacy may be affected by the degree to which it binds to the proteins within blood plasma. ... Hydroxylation is any chemical process that introduces one or more hydroxyl groups (-OH) into a compound (or radical) thereby oxidising it. ... Example of glucuronidation Glucuronidation of alcohols and acids Glucuronidation is a major inactivating pathway for a huge variety of exogenous and endogenous molecules, including drugs, polluants, bilirubin, androgens, estrogens, mineralocorticoids, glucocorticoids, fatty acid derivatives, retinoids and bile acids. ... Isozymes, (or isoenzymes) are isoforms (closely related variants) of enzymes. ... Cytochrome P450 Oxidase (CYP2E1) Cytochrome P450 oxidase (commonly abbreviated CYP) is a generic term for a large number of related, but distinct, oxidative enzymes (EC 1. ... The kidneys are the organs that filter wastes (such as urea) from the blood and excrete them, along with water, as urine. ...


Veterinary uses

Phenobarbital is one of the initial drugs of choice to treat epilepsy in dogs, and is the initial drug of choice to treat epilepsy in cats.[23] Trinomial name Canis lupus familiaris The dog (Canis lupus familiaris) is a domestic subspecies of the wolf, a mammal of the Canidae family of the order Carnivora. ...


It may also be used to treat seizures in horses when benzodiazepine treatment has failed or is contraindicated.[24] Binomial name Equus caballus Linnaeus, 1758 The horse (Equus caballus, sometimes seen as a subspecies of the Wild Horse, Equus ferus caballus) is a large odd-toed ungulate mammal, one of ten modern species of the genus Equus. ... Alprazolam 2 mg tablets The benzodiazepines (pronounced , or benzos for short) are a class of psychoactive drugs considered minor tranquilizers with varying hypnotic, sedative, anxiolytic, anticonvulsant, muscle relaxant and amnesic properties, which are mediated by slowing down the central nervous system. ...


Illicit Use

The High Incident Bandits used phenobarbital prior to committing the North Hollywood Bank of America robbery.[citation needed] The North Hollywood shootout was an armed confrontation between two heavily-armed and armored bank robbers, Larry Phillips, Jr. ...


Phenobarbital was mixed with vodka and consumed by the Heaven's Gate Cult members to commit suicide on March 26, 1997.[citation needed] Vodka bottling machine, Shatskaya Vodka Shatsk, Russia Vodka (Polish: wódka, Russian: водка) is one of the worlds most popular distilled beverages. ... The logo used by the Heavens Gate group Heavens Gate was the name of an American religious group led by Marshall Applewhite and Bonnie Nettles. ...


References

  1. ^ WHO Model List of Essential Medicines (PDF). World Health Organization (March 2005). Retrieved on 2006-03-12.
  2. ^ a b NICE (2005-10-27). CG20 Epilepsy in adults and children: NICE guideline. NHS. Retrieved on 2006-09-06.
  3. ^ Phenobarbital. Epilepsy Foundation. Retrieved on 2006-09-07.
  4. ^ a b British Medical Association, Royal Pharmaceutical Society of Great Britain, Royal College of Paediatrics and Child Health and Neonatal and Paediatric Pharmacists Group (2006). "4.8.1 Control of epilepsy", British National Formulary for Children, 255-6. ISBN 0-85369-676-4. 
  5. ^ Sneader, Walter (2005-06-23). Drug Discovery. John Wiley and Sons, 369. ISBN 0-471-89979-8. 
  6. ^ Ole Daniel Enersen. Alfred Hauptmann.
  7. ^ Scott,, Donald F (1993-02-15). The History of Epileptic Therapy. Taylor & Francis, 59-65. ISBN 1-85070-391-4. 
  8. ^ a b Rachel Sheremeta Pepling (06 2005). "Phenobarbital". Chemical and Engineering News 83 (25). Retrieved on 2006-09-06. 
  9. ^ Michelle Meadows (January-February 2007). The FDA Takes Action Against Unapproved Drugs. FDA Consumer magazine. Retrieved on 2007-09-27.
  10. ^ John M. Pellock, W. Edwin Dodson, Blaise F. D. Bourgeois (2001-01-01). Pediatric Epilepsy. Demos Medical Publishing, 169. ISBN 1-888799-30-7. 
  11. ^ Robert Baumann (2005-02-14). Febrile Seizures. eMedicine. WebMD. Retrieved on 2006-09-06.
  12. ^ various (March 2005). Diagnosis and management of epilepsies in children and young people 15. Scottish Intercollegiate Guidelines Network. Retrieved on 2006-09-07.
  13. ^ a b British National Formulary 51
  14. ^ Taylor S, Tudur Smith C, Williamson PR, Marson AG (2003). "Phenobarbitone versus phenytoin monotherapy for partial onset seizures and generalized onset tonic-clonic seizures.". Cochrane Database Systematic Reviews (2). doi:10.1002/14651858.CD002217. PMID 11687150. Retrieved on 2006-09-06. 
  15. ^ Tudur Smith C, Marson AG, Williamson PR (2003). "Carbamazepine versus phenobarbitone monotherapy for epilepsy". Cochrane Database of Systematic Reviews (1). doi:10.1002/14651858.CD001904. PMID 12535420. Retrieved on 2006-09-06. 
  16. ^ British Medical Association, Royal Pharmaceutical Society of Great Britain, Royal College of Paediatrics and Child Health and Neonatal and Paediatric Pharmacists Group (2006). "4.8.2 Drugs used in status epilepticus", British National Formulary for Children, 269. ISBN 0-85369-676-4. 
  17. ^ Kälviäinen R, Eriksson K, Parviainen I (2005). "Refractory generalised convulsive status epilepticus : a guide to treatment.". CNS Drugs 19 (9): 759-68. PMID 16142991. 
  18. ^ John M. Pellock, W. Edwin Dodson, Blaise F. D. Bourgeois (2001-01-01). Pediatric Epilepsy. Demos Medical Publishing, 152. ISBN 1-888799-30-7. 
  19. ^ Raj D Sheth (2005-03-30). Neonatal Seizures. eMedicine. WebMD. Retrieved on 2006-09-06.
  20. ^ Booth D, Evans DJ (2004). "Anticonvulsants for neonates with seizures". Cochrane Database of Systematic Reviews (3). doi:10.1002/14651858.CD004218.pub2. PMID 15495087. Retrieved on 2006-09-06. 
  21. ^ a b Rania Habal (2006-01-27). Barbiturate Toxicity. eMedicine. WebMD. Retrieved on 2006-09-14.
  22. ^ King, Wayne. "Abbie Hoffman Committed Suicide Using Barbiturates, Autopsy Shows", The New York Times, April 19, 1989. Retrieved on 2008-04-09. 
  23. ^ Thomas, WB (2003). Seizures and narcolepsy. In: Dewey, Curtis W. (ed.) A Practical Guide to Canine and Feline Neurology. Ames, Iowa: Iowa State Press. ISBN 0-8138-1249-6. 
  24. ^ (February 8, 2005) in Kahn, Cynthia M., Line, Scott, Aiello, Susan E. (ed.): The Merck Veterinary Manual, 9th ed., John Wiley & Sons. ISBN 0-911910-50-6. 
There are several sulphonamide-based groups of drugs. ... Acetazolamide, sold under the trade name Diamox®, is a carbonic anhydrase inhibitor that is used to treat glaucoma, epileptic seizures, benign intracranial hypertension and altitude sickness. ... Ethoxzolamide (6-ethoxybenzothiazole-2-sulfonamide, alternatively known as Ethoxyzolamide) is a sulfonamide medication that functions as a carbonic anhydrase inhibitor. ... Sultiame (rINN, also known as sulthiame) is a sulfonamide and inhibitor of the enzyme carbonic anhydrase. ... Zonisamide (brand name Zonegran®) is an anticonvulsant used as an adjunctive therapy in adults with partial-onset seizures. ... The propionate (also propanoate) ion is C2H5COO− (propionic acid minus one hydrogen ion). ... Beclamide (marketed as Chloracon, Hibicon, Posedrine, Nydrane, Seclar, and other names) is a propionate and was used as a sedative and as an anticonvulsant. ... An aldehyde. ... Paraldehyde is the cyclic form of three acetaldehyde molecules (a trimer). ... A bromide is a phrase, or person who uses phrases, which have been used and repeated so many times as to become either insincere in their meaning, or seem like an attempt at trying to explain the obvious. ... Potassium bromide (KBr) is a salt, used as an anticonvulsant and a sedative in the 1800s. ... Sodium bromide is the chemical compound with the formula NaBr. ... In pharmacology, a psycholeptic is a medication which produces a calming effect upon the patient. ... Hypnotic drugs are a class of drugs that induce sleep, used in the treatment of severe insomnia. ... A sedative is a substance that depresses the central nervous system (CNS), resulting in calmness, relaxation, reduction of anxiety, sleepiness, and slowed breathing, as well as slurred speech, staggering gait, poor judgment, and slow, uncertain reflexes. ... A section of the Anatomical Therapeutic Chemical Classification System. ... An aldehyde. ... Acetylglycinamide chloral hydrate is a hypnotic/sedative. ... Chloral hydrate, also known as trichloroacetaldehyde monohydrate, 2,2,2-trichloro-1,1-ethanediol, and under the tradenames Aquachloral, Novo-Chlorhydrate, Somnos, Noctec, and Somnote, is a sedative and hypnotic drug as well as a chemical reagent and precursor. ... Chloralodol is a hypnotic/sedative. ... Dichloralphenazone is a 1:2 mixture of antipyrine with chloral hydrate. ... Paraldehyde is the cyclic form of three acetaldehyde molecules (a trimer). ... The structural formula of 2-butyne, a simple alkyne-containing molecule Alkynes are hydrocarbons that have at least one triple bond between two carbon atoms, with the formula CnH2n-2. ... Ethchlorvynol is a sedative and hypnotic drug. ... Ethinamate (Valamin®, Valmid®) is a short-acting sedative-hypnotic medication used to treat insomnia. ... Hexapropymate is a hypnotic/sedative. ... Methylpentynol is a hypnotic/sedative. ... Barbiturates are drugs that acts as central nervous system (CNS) depressants, and by virtue of this they produce a wide spectrum of effects, from mild sedation to anesthesia. ... Allobarbital is a barbiturate derivative invented in 1912 by Ernst Preiswerk and Ernst Grether working for CIBA. It was used primarily as an anticonvulsant [1] although it has now been replaced by newer drugs with improved safety profiles. ... Amobarbital (formerly known as amylobarbitone) is a drug that is a barbiturate derivative. ... This page meets Wikipedias criteria for speedy deletion. ... Barbital (marketed under the brand name Veronal), also called barbitone, was the first commercially marketed barbiturate. ... Butobarbital (also known as Soneryl) is a drug which is a barbiturate derivative. ... Cyclobarbital, also known as cyclobarbitol or cyclobarbitone, is a drug which is a barbiturate derivative. ... Ethallobarbital is a drug which is a barbiturate derivative. ... Heptabarbital is a drug which is a barbiturate derivative. ... Hexobarbital is a barbiturate derivative having hypnotic and sedative effects. ... Methohexital is a short-acting intravenous anaesthetic induction agent, that is, used to commence anaesthesia. ... Pentobarbital is a short acting barbiturate that is available as both a free acid and a sodium salt, the former of which is only slightly soluble in water and ethanol. ... Proxibarbital (Ipronal) is a barbiturate derivative invented in the 1970s. ... Reposal is a barbiturate derivative invented in the 1960s in Denmark. ... Secobarbital (marketed by Eli Lilly and Company under the brand names Seconal® and Tuinal) is a barbiturate derivative drug. ... Talbutal (Lotusate®), also called 5-allyl-5-sec-butylbarbituric acid, is a barbiturate with a short to intermediate duration of action. ... Sodium thiopental, better known as Sodium Pentothal (a trademark of Abbott Laboratories), thiopental, thiopentone sodium, or trapanal, is a rapid-onset short-acting barbiturate general anaesthetic. ... Vinylbital, also known as butylvinyl, is a drug which is a barbiturate derivative. ... Vinbarbital is a drug which is a barbiturate derivative. ... Alprazolam 2 mg tablets The benzodiazepines (pronounced , or benzos for short) are a class of psychoactive drugs considered minor tranquilizers with varying hypnotic, sedative, anxiolytic, anticonvulsant, muscle relaxant and amnesic properties, which are mediated by slowing down the central nervous system. ... Brotizolam (marketed under brand name Lendormin) is a drug which is thienobenzodiazepine (a benzodiazepine derivative). ... Cinolazepam is a drug which is a benzodiazepine derivative. ... Doxefazepam (marketed under brand name Doxans) is a drug which is a benzodiazepine derivative. ... Estazolam (ProSom®) is a benzodiazepine commonly prescribed for short-term treatment of insomnia. ... Flunitrazepam (IPA: ; is marketed by Roche under the trade name Rohypnol. ... Flurazepam (marketed under the brand names Dalmane and Dalmadorm) is a drug which is a benzodiazepine derivative. ... Flutoprazepam (Restas, KB-509) is a drug which is a benzodiazepine derivative. ... Loprazolam (Triazulenone) marketed under the brand names Dormonoct®, Havlane®, Sonin®, Somnovit®, is a drug which is an imidazole benzodiazepine derivative. ... Lormetazepam (Noctamid®, Ergocalm®, Loramet®, also known as methyllorazepam, is a drug which is a benzodiazepine derivative. ... Nitrazepam (marketed under the trade names Mogadon®, Nitredon®, Nilandron®) is a powerful hypnotic drug, which is a benzodiazepine derivative. ... Nimetazepam (marketed under brand name Erimin®) is a drug which is a benzodiazepine derivative. ... Midazolam (marketed under brand names Versed®, Hypnovel®, Dormicum® and Dormonid®, pronounced ) is a drug which is a benzodiazepine derivative. ... Quazepam (brand names Doral®, Dormalin®) is a long-acting benzodiazepine used to treat insomnia. ... Temazepam (marketed under brand names Restoril®, Normison®, Planum®, Tenox® and Temaze®) is a benzodiazepine derivative with powerful hypnotic properties. ... Triazolam (Halcion®, Novodorm®, Songar®) belongs to benzodiazepine group of drugs. ... Gamma-Hydroxybutyric acid (4-hydroxybutanoic acid, C4H8O3), commonly abbreviated GHB, is a neuroprotective therapeutic drug that is illegal in a number of countries[1], and is a naturally-occurring substance found in the central nervous system, wine, beef, small citrus fruits, and almost all living creatures in small amounts. ... Gamma-Hydroxybutyric acid (4-hydroxybutanoic acid, C4H8O3), commonly abbreviated GHB, is a neuroprotective therapeutic drug that is illegal in a number of countries[1], and is a naturally-occurring substance found in the central nervous system, wine, beef, small citrus fruits, and almost all living creatures in small amounts. ... gamma-Butyrolactone, also known as GBL, butyrolactone, 1,4-lactone, 4-butyrolactone, 4-hydroxybutyric acid lactone, and gamma-hydroxybutyric acid lactone, is a hygroscopic colorless oily liquid with a weak characteristic odor and is soluble in water. ... (Redirected from 1,4 Butanediol) Chemical structure of 1,4-butanediol 1,4-Butanediol (C4H10O2, molecular weight 90. ... A melatonin receptor is a G protein-coupled receptor which binds melatonin. ... Agomelatine (Valdoxan®) is chemical compound that is structurally closely related to melatonin. ... Melatonin, 5-methoxy-N-acetyltryptamine, is a hormone found in all living creatures from algae[1] to humans, at levels that vary in a diurnal cycle. ... Ramelteon, marketed as Rozerem by Takeda Pharmaceuticals North America, is the first in a new class of sleep agents that selectively binds to the MT1 and MT2 receptors in the suprachiasmatic nucleus (SCN), versus binding to GABA-A receptors, such as with drugs like Ambien CR, Lunesta, and Sonata. ... The nonbenzodiazepines are comparatively new drugs whose actions are very similar to those of the benzodiazepines, but are structurally unrelated to the benzodiazepines and are believed to have fewer side effects. ... Eszopiclone, marketed by Sepracorand marco under the brand-name Lunesta®, is a nonbenzodiazepine hypnotic agent (viz. ... Indiplon (INN and USAN) is a nonbenzodiazepine, hypnotic sedative being developed in 2 formulations - an immediate release product for sleep onset and a modified-release version for sleep maintenance. ... Pazinaclone (DN-2327) is a sedative and anxiolytic drug in the cyclopyrrolone family of drugs. ... Saripidem is a sedative and anxiolytic drug in the imidazopyridine family, which is related to the better known drugs zolpidem and alpidem. ... Suproclone is a sedative and anxiolytic drug in the cyclopyrrolone family of drugs, developed by the French pharmaceutical company Rhône-Poulenc. ... Suriclone (Suril) is a sedative and anxiolytic drug in the cyclopyrrolone family of drugs. ... Zaleplon (marketed under the brand names Sonata and Starnoc) is a sedative/hypnotic, mainly used for insomnia. ... Zolpidem is a prescription short-acting nonbenzodiazepine hypnotic that potentiates gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter, by binding to gamma-aminobutyric acid receptors. ... Zopiclone (trade names: Imovaneâ„¢ and Zimovaneâ„¢) is a novel hypnotic agent used in the treatment of insomnia. ... The chemical structure of 2,6-piperidinedione, the most common isomer Piperidinediones are a derivatives of piperidine with two ketone functional groups. ... Glutethimide is a hypnotic sedative that was introduced in 1954 as a safe alternative to barbiturates to treat insomnia. ... Methyprylon is a sedative of the piperidinedione derivative family. ... Pyrithyldione is a hypnotic/sedative. ... Afloqualone (Arofuto) is an analogue of methaqualone developed in the 1980s in Japan. ... Cloroqualone is an analogue of methaqualone developed in the 1980s and marketed mainly in France and some other European countries. ... Diproqualone is an analogue of methaqualone developed in the 1980s and marketed mainly in France and some other european countries. ... Etaqualone (Aolan, Athinazone) is an analogue of methaqualone which was developed in the 1960s and marketed mainly in France and some other European countries. ... Mebroqualone is an analogue of mecloqualone which presumably has similar sedative and hypnotic properties to its parent compound. ... Mecloqualone (Nubarene) is an analogue of methaqualone which was first made in 1960 [1] and marketed mainly in France and some other european countries. ... Methaqualone tablets and capsules. ... Methylmethaqualone is an analogue of methaqualone which presumably has similar sedative and hypnotic properties to its parent compound. ... Apronal (or apronalide) is a hypnotic/sedative. ... A bromide is a phrase, or person who uses phrases, which have been used and repeated so many times as to become either insincere in their meaning, or seem like an attempt at trying to explain the obvious. ... Bromisoval (or bromisovalum) is a hypnotic/sedative. ... Carbromal is a hypnotic/sedative. ... Clomethiazole (also called Chlormethiazole) is a sedative and hypnotic that is widely used in treating and preventing symptoms of acute alcohol withdrawal. ... Dexmedetomidine is a sedative medication used by intensive care units and anesthesiologists. ... Niaprazine (Nopron) is a piperazine derivative drug which acts as a sedating antihistamine. ... Propiomazine (brand names: Largon, Propavan, Indorm) is an atypical antipsychotic, which is used to treat negative and positive symptoms of schizophrenia, acute mania with bipolar disorder, agitation and psychotic symptoms in dementia. ... Scopolamine, also known as hyoscine, is a tropane alkaloid drug obtained from plants of the family Solanaceae (nightshades), such as henbane or jimson weed (Datura species). ... Sulfonmethane is a chemical compound used as a hypnotic drug. ... 2,2,2-Trichloroethanol is an organic compound related to ethanol, except the hydrogen atoms at position 2 are replaced with chlorine atoms. ... Triclofos is a sedative drug used rarely for treating insomnia, usually as a second-line treatment after other drugs have failed. ... Binomial name L. & Maillefer Valerian (Valeriana officinalis, Valerianaceae) is a hardy perennial flowering plant, with heads of sweetly scented pink or white flowers. ... Valnoctamide has been used in France as a tranquilizer and muscle relaxant since 1964[3] and as an anticonvulsant since starting in 1969 in Portugal. ...

  Results from FactBites:
 
Phenobarbital: Encyclopedia of Neurological Disorders (552 words)
Phenobarbital is a barbiturate, a drug that has sedative and hypnotic effects.
Phenobarbital is used to control the seizures that occur in epilepsy, and can relieve anxiety.
Phenobarbital is available in tablet or capsule form, and as a liquid.
Pb Side Effects, and Drug Interactions - Phenobarbital - RxList Monographs (991 words)
If an individual appears to be intoxicated with alcohol to a degree that is radically disproportionate to the amount of alcohol in his or her blood, the use of barbiturates should be suspected.
Infants physically dependent on phenobarbital may be given a lower dose of phenobarbital at 3 to 10 mg/kg/day.
Because the effect of phenobarbital on the metabolism of phenytoin is not predictable, phenytoin and phenobarbital blood levels should be monitored more frequently if these drugs are given concurrently.
  More results at FactBites »

 
 

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