Barbit Elixir 100ml

Pharmacology

Phenobarbital, the longest-acting barbiturate, is used for its anticonvulsant and sedative-hypnotic properties in the management of all seizure disorders except absence (petit mal). Phenobarbital acts on GABAA receptors, increasing synaptic inhibition. This has the effect of elevating seizure threshold and reducing the spread of seizure activity from a seizure focus. Phenobarbital may also inhibit calcium channels, resulting in a decrease in excitatory transmitter release. The sedative-hypnotic effects of phenobarbital are likely the result of its effect on the polysynaptic midbrain reticular formation, which controls CNS arousal.

Dosage & Administration:

Adult Dose:

• Sedation: 30-120 mg daily in 2-3 divided doses (max 400 mg/day).
• Status Epilepticus: 100-300 mg daily at bedtime.
• Seizures: 60-180 mg/day at night.
• Insomnia: 100-200 mg at bedtime (max 400 mg/day).
• Hypnotic: 100-320 mg (not for >2 weeks).
• Elderly/Hepatic Impairment: Reduce dose.
• Severe Hepatic Impairment: Contraindicated.

Child Dose:

• Sedation: 2 mg/kg daily in 3 divided doses.
• Status Epilepticus: 3-5 mg/kg or 125 mg/m² daily.
• Seizures:
  • Neonates: 3-5 mg/kg/day in 1-2 doses.
  • Infants: 5-6 mg/kg/day in 1-2 doses.
  • 1-5 years: 6-8 mg/kg/day in 1-2 doses.
  • 6-12 years: 4-6 mg/kg/day in 1-2 doses.
  • >12 years: 1-3 mg/kg/day in 1-2 doses, or 50-100 mg BID/TID.
• Preoperative Sedation: 1-3 mg/kg pre-op.

Renal Dose:

• Impairment: Reduce dose.
• Severe Impairment: Contraindicated.

Interaction

The concomitant use of Alcohol or other CNS depressants may produce additive CNS depressant effects.

Overdose Effects

The toxic dose of barbiturates varies considerably. In general, an oral dose of 1 gram of most barbiturates produces serious poisoning in an adult. Death commonly occurs after 2 to 10 grams of ingested barbiturate. Acute overdosage with barbiturates is manifested by CNS and respiratory depression Treatment of overdosage is mainly supportive and immediate hospitalization is necessary.

Contraindications

Phenobarbital is contraindicated in patients with known Phenobarbital sensitivity or a history of latent porphyria.

Side Effects

The most common adverse reaction is somnolence. Other less frequent adverse reactions are agitation, confusion, hyperkinesia, ataxia, CNS depression, nightmares, nervousness, psychiatric disturbance, hallucinations, insomnia, anxiety, dizziness, thinking abnormality, apnea, bradycardia, hypotension, nausea, vomiting, and constipation.

Pregnancy & Lactation

Pregnancy Category D. Phenobarbital can cause fetal damage when administered to a pregnant woman. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be at risk of the potential hazard to the fetus. Caution should be taken when Phenobarbital is administered to a nursing woman since small amounts of Phenobarbital are excreted in the milk.

Precautions & Warnings

Tolerance and psychological and physical dependence may occur with continuing use. Barbit Elixir should be administered with caution to patients who are mentally depressed, have suicidal tendencies, or have a history of drug abuse. In patients with hepatic damage, Barbit Elixir should be administered with caution and initially reduced doses.

Storage Conditions

Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.