Phenobarbital

Used as an alternative in GTC and partial (not DOC). Had been DOC for febrile seizures, dubious benefit.

About as effective as PHT, but very sedating. Also used for status epilepticus

Same dose PO, IV, or IM. MDF = q d.

Start slowly to minimize sedation.

℞ Adult loading: 20 mg/kg slow IV (administer at rate < 100 mg/min). Maintenance: 30–250 mg/d (usually divided BID-TID). Peds loading: 15–20 mg/kg. Maintenance: 2–6 mg/kg/d (usually divided BID). Supplied: tabs 15 mg, 30 mg, 60 mg, 100 mg; elixir 20 mg/5-ml.

Phenobarbital is a potent inducer of hepatic enzymes that metabolize other ASMs.

Cognitive impairment (may be subtle and may outlast the administration of the drug by at least several months), thus avoid in peds; sedation; paradoxical hyperactivity (especially in peds); may cause hemorrhage in a newborn if the mother is on phenobarbital

Phenobarbital, also known as phenobarbitone or phenobarb, is a medication recommended by the World Health Organization for the treatment of certain types of epilepsy in developing countries.

In the developed world it is commonly used to treat seizures in young children, while other medications are generally used in older children and adults. It may be used intravenously, injected into a muscle, or taken by mouth.

The injectable form may be used to treat status epilepticus.

Phenobarbital is occasionally used to treat trouble sleeping, anxiety, and drug withdrawal and to help with surgery.

It usually begins working within five minutes when used intravenously and half an hour when administered orally.

Its effects last for between four hours and two days.