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.

Phenobarbital works by depressing the central nervous system, thereby reducing neuronal activity, which helps control seizure activity and induce sedation.

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.

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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

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.

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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.

Citations

Phenobarbital Compared with Phenytoin for the Treatment of Neonatal Seizures | NEJM

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Frequently Asked Questions

1. What is the drug phenobarbital used to treat?

Phenobarbital is used for controlling seizures. The medication is also used for relieving anxiety.

2. How much phenobarbital should I take for anxiety?

To maintain sedation and alleviate anxiety, tension, and apprehension you can take 30 to 120 mg/day PO, divided into two to three doses. In debilitated patients, the manufacturer recommends a lower dose.

3. How fast does phenobarbital work?

Phenobarbital can be given as an injection, a liquid elixir, or as tablets. Each has its own rate of action and recommended dosages. Tablets or elixirs start working in about 60 minutes and last for 10 to 12 hours, depending on the dosage and individual metabolism.

4. How strong is phenobarbital?

The total daily dose of phenobarbital is then divided into three to four divided doses, not to exceed 600 mg per day. If withdrawal symptoms appear on the first day of treatment, a loading dose of 100 to 200 mg phenobarbital may be administered intravenously (IM) in addition to the oral dose.

5. What is phenobarbital used for in babies?

Phenobarbital is used to treat infants (ages 0 to 1 year) who have any type of seizure disorder, as well as other children who have generalized, partial, or febrile seizures. It's also used to treat status epilepticus (seizures lasting greater than 15 minutes).

6. What happens if you take phenobarbital?

As your body adjusts to the medication, you may experience dizziness, drowsiness, excitement, headache, tiredness, loss of appetite, nausea, or vomiting. Notify your doctor or pharmacist right away if any of these side effects persist or worsen.

7. What are the long-term effects of phenobarbital?

Effects on the musculoskeletal system: Chronic phenobarbital use is linked to an increased risk of osteoporosis, decreased bone mineral density, increased bone fractures, and palmar fibromatosis, which is characterized by a thickening and tightening of the tissue beneath the skin in the hands.

8. Does phenobarbital cause depression?

Phenobarbital increases the risk of depression in epileptic patients and should be avoided whenever clinically possible, especially in patients with a personal or family history of affective disorder.

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