Overview Of Phenobarbital
Phenobarbital is a barbiturate medication primarily used to manage and prevent various types of seizures, including generalized tonic-clonic and partial seizures. It is also used in the treatment of status epilepticus and can serve as a sedative for anxiety or preoperative sedation.
Specifically, the phenobarbital structure contributes to its therapeutic actions by facilitating its receptor binding and action on the CNS to inhibit excessive or abnormal neuronal activity.
How Phenobarbital Works?
Phenobarbital mechanism of action involves depressing the central nervous system by enhancing the activity of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter. This action lowers neuronal excitability, which is useful for seizure control, sedation and anxiety.
Phenobarbital uses
Seizure Control
- Epilepsy: Phenobarbital is widely used to treat various types of seizures, including generalized tonic-clonic (grand mal) seizures and partial seizures.
- Status Epilepticus: It is effective in controlling status epilepticus, a medical emergency characterized by prolonged or repeated seizures without recovery between them.
Sedation
- Preoperative Sedation: Phenobarbital can be used to sedate patients before surgical or medical procedures.
- Anxiety and Insomnia: In some cases, it is used to manage severe anxiety and insomnia, although this is less common due to the risk of dependence.
Detoxification
- Withdrawal Symptoms: It is sometimes used to manage withdrawal symptoms in individuals undergoing detoxification from certain substances, such as alcohol or other barbiturates.
How To Take Phenobarbital
- Phenobarbital is available as a tablet and an elixir (liquid) to be taken orally. It’s typically taken one to three times per day.
- Follow the directions on your prescription label exactly, and ask your doctor or pharmacist to explain any parts you don’t understand. Take the phenobarbital exactly as prescribed.
- If you take phenobarbital for an extended period of time, it may no longer control your symptoms as well as it worked at the beginning of your treatment.
- Discuss how you are feeling during your treatment with your doctor. Phenobarbital has the potential to become addictive.
- Do not take a higher dose, take it more frequently, or take it for a longer period of time than your doctor has prescribed.Do not discontinue phenobarbital without first consulting your doctor.
- If you stop taking phenobarbital abruptly, you may experience withdrawal symptoms such as anxiety, muscle twitching, uncontrollable shaking of a part of your body, weakness, dizziness, changes in vision, nausea, vomiting, seizures, confusion, difficulty falling or staying asleep, or dizziness or fainting when rising from a lying position.
- Your doctor will gradually reduce your dose.
Phenobarbital Side Effects
- Drowsiness
- Headache
- Dizziness
- Excitement (especially in children)
- Nausea
- Vomiting
- Slowed breathing
- Difficulty breathing
- Swelling of the eyes, lips, or cheeks
- Rash
- Blisters
- Peeling skin
- Fever
- Confusion
Phenobarbital Contraindications and Precautions
- Before taking phenobarbital, inform your doctor or pharmacist if you are allergic to it, other barbiturates, anti-seizure medications, or any other allergies. Inactive ingredients present in this product may cause allergic reactions or other problems.
- Tell your doctor or pharmacist about your medical history, especially if you have any of the following: certain hormone problems (adrenal disease such as Addison’s disease), liver problems, kidney problems, lung problems.
- This liquid form may contain alcohol or sugar. If you have diabetes, alcoholism, liver disease, or any other condition that requires you to limit or avoid these substances in your diet, proceed with caution.
- Older adults may be more sensitive to the drug’s side effects, particularly drowsiness and dizziness. Drowsiness, confusion, and dizziness can increase the likelihood of a fall.
- Children may be more sensitive to the drug’s side effects. In young children, this drug can often cause excitement rather than drowsiness.
- This medication should not be used while pregnant. It can harm an unborn child. However, because untreated seizures are a serious condition that can harm both pregnant women and their unborn child, do not stop taking this medication unless your doctor tells you to.
- This medication is excreted in breast milk and may cause excessive sleepiness or feeding difficulties in nursing infants. Before breastfeeding, consult your doctor.
- This medication may cause a decrease in your folic acid and vitamin K levels, increasing your risk of spinal cord defects. As a result, consult your doctor to ensure that you are getting enough folic acid and vitamin K.
- Infants born to mothers who used this medication during pregnancy may exhibit symptoms such as fussiness, shaking, or bleeding. If you notice any of these symptoms in your newborn, contact your doctor right away.
Overdose
If you forget to take any dose or by mistake miss a dose, take it as soon as you remember it. If it is already the time for the next dose, skip the forgotten dose. Take your next medicine at the regular time schedule. Do not double the dose
Missed Dose
Missing one or two-dose of Phenergan won’t show any effect on your body. The skipped dose causes no problem. But with some medication, it won’t work if you don’t take the dosage on time. If you miss a dose some sudden chemical change may affect your body. In some cases, your doctor would advise you to take the prescribed medicine as soon as possible if you have missed the dose.
Storage
The medicine should not come in direct contact with heat, air, and light may damage your medicines. Exposure to medicine might cause some harmful effects or serious side effects. The medicine must be kept in a safe place and out of children’s reach.
Phenobarbital vs Diazepam
| Phenobarbital | Diazepam |
|---|---|
| Phenobarbital is a barbiturate. Phenobarbital reduces brain and nervous system activity. | Diazepam, originally marketed as Valium, is a benzodiazepine anxiolytic medication. |
| Phenobarbital is a medication used for preventing seizures. | It is commonly used to treat anxiety, seizures, alcohol withdrawal syndrome, benzodiazepine withdrawal syndrome, muscle spasms, difficulty sleeping, and restless legs syndrome. |
| Phenobarbital is more potent when compared to diazepam. | Diazepam is easier to titrate. |
