Secobarbital

Mechanism :

Depresses CNS activity by binding to barbiturate site at GABA-receptor complex enhancing GABA activity, depressing reticular activity system.

Indication :

Sedative

Contraindications :

Hypersensitivity to barbiturates or any component of the formulation; marked hepatic impairment; dyspnea or airway obstruction; porphyria.

Dosing :

Sedative:

6 mg/kg PO divided every 8 hours.

Pre-procedure Sedation:

2-6 mg/kg PO 1-2 hours before surgery, no more than 100 mg/dose.

Adverse Effect :

Drowsiness, agitation, CNS depression, sleep disorder, confusion, constipation, dizziness, exfoliative dermatitis, hepatotoxicity, megaloblastic anemia, nightmares.

Interaction :

Calcium Channel Blockers: Barbiturates may increase the metabolism of Calcium Channel Blockers.
CNS Depressants: May enhance the adverse/toxic effect of other CNS Depressants.
Estrogen derivative and Progestins: Barbiturates may diminish the therapeutic effect.
Tricyclic Antidepressants: Barbiturates may increase the metabolism of Tricyclic Antidepressants.
Thiazide and Thiazide-Like Diuretics: Barbiturates may enhance the orthostatic hypotensive effect of Thiazide and Thiazide-Like Diuretics.

Hepatic Dose :

In patients with hepatic damage, barbiturates should be administered with caution and initially in reduced doses. Barbiturates should not be administered to patients showing the premonitory signs of hepatic coma.