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Pronunciation: see-koe-BAR-bih-tahl SO-dee-uhm
Class: Sedative and hypnotic, Barbiturate
Seconal Sodium Pulvules
- Capsules 100 mg
Depresses sensory cortex, decreases motor activity, alters cerebellar function, and produces drowsiness, sedation, and hypnosis.
Secobarbital absorption is rapid; the rate is increased if the sodium salt is ingested as a dilute solution or taken on an empty stomach.
Secobarbital has very high lipid solubility and high protein binding. The drug is distributed to all tissues and fluids, with high concentrations in the brain, liver, and kidneys.
Metabolism of secobarbital is primarily by the hepatic microsomal enzyme system.
Secobarbital is eliminated renally. The inactive metabolites are excreted as conjugates of glucuronic acid. The t ½ is 15 to 40 h (mean, 28 h).
Secobarbital's onset of action is 10 to 15 min (PO).
Secobarbital's duration of action is 3 to 4 h (PO).
Indications and Usage
Short-term (up to 2 wk) treatment of insomnia; induction of basal hypnosis before anesthesia (parenteral form); sedation (parenteral form).
Control of status epilepticus or acute seizure episodes.
Hypersensitivity to barbiturates; history of addiction to sedative/hypnotic drugs; history of porphyria; severe liver impairment; respiratory disease with dyspnea; nephritic patients.
Dosage and AdministrationInsomnia
PO At bedtime 100 mg.Hypnotic
IM 100 to 200 mg; IV 50 to 250 mg.Sedation
PO 30 to 50 mg 3 or 4 times daily.Children
PO/PR 2 to 6 mg/kg. For rectal administration, dilute to 1% to 1.5% solution.Preoperative Sedation
PO 200 to 300 mg 1 to 2 h before surgery.Children
PO 2 to 6 mg/kg (max, 100 mg) 1 to 2 h before surgery.Sedation/Preanesthesia
IM (light sedation) 1 mg/kg 15 min before procedure.Children
IM 4 to 5 mg/kg.Convulsions
IM/IV 1.1 to 2.2 mg/kg. Max IV rate 50 mg/15 sec. Maximum adult IM dose 500 mg or 5 mL volume regardless of concentration.
Store oral preparation at room temperature. Refrigerate parenteral form. Use only clear solution; discard if precipitate forms or solution becomes cloudy.
Drug InteractionsAlcohol, CNS depressants
May produce additive CNS depressant effects.Anticoagulants (eg, warfarin), beta blockers (eg, metoprolol, propranolol), verapamil, quinidine, theophyllines
May reduce activity of these drugs.Anticonvulsants
May reduce serum concentrations of carbamazepine, valproic acid, and succinimides. Valproic acid may increase barbiturate serum levels.Corticosteroids
May reduce effectiveness of corticosteroids.Estrogens, estrogen-containing oral contraceptives
May reduce contraceptive effect and estrogen effect.
Laboratory Test Interactions
May increase bromsulphalein retention; may cause decreased serum bilirubin concentrations; false-positive phentolamine test results; decreased response to metyrapone; impaired absorption of radioactive cyanocobalamin.
Bradycardia; hypotension; syncope.
Drowsiness; agitation; confusion; headache; hyperkinesia; ataxia; CNS depression; paradoxical excitement; nightmares; psychiatric disturbances; hallucinations; insomnia; dizziness.
Nausea; vomiting; constipation.
Blood dyscrasias (eg, agranulocytosis, thrombocytopenia).
Hypoventilation; apnea; laryngospasm; bronchospasm.
Hypersensitivity reactions (eg, angioedema, rashes, exfoliative dermatitis); fever; liver damage; injection site reactions (eg, local pain, thrombophlebitis).
Obtain baseline Hct, Hgb, RBC, and LFT results (transaminase levels and bilirubin). Periodically evaluate those results if patient is on long-term therapy.
Category D .
Excreted in breast milk.
May respond with excitement rather than depression.
More sensitive to drug effects; dosage reduction is required.
Use drug with caution; dosage reduction may be required.
Use drug with caution; dosage reduction may be required.
Tolerance or psychological and physical dependence may occur with continued use.
Do not exceed maximum IV rate 50 mg/15 sec; respiratory depression, apnea, and hypotension may result. Parenteral solutions are highly alkaline; extravasation may cause tissue damage and necrosis. Inadvertent intraarterial injection may lead to arterial spasm, thrombosis and gangrene.
Status epilepticus may result from abrupt discontinuation.
CNS and respiratory depression, Cheyne-Stokes respiration, areflexia, oliguria, tachycardia, hypotension, lowered body temperature, coma, pulmonary edema, death.
- Explain that this medication may cause psychological and physical dependence. Emphasize that it is important not to increase dose without consulting health care provider.
- Discuss ways to facilitate sleep (quiet, darkened room; avoidance of caffeine and nicotine; warm bath, warm milk; deep breathing; relaxation; self-hypnosis).
- Inform patient that it may take a few doses to achieve noticeable sleep benefit.
- Instruct patient to notify health care provider immediately of sudden onset of fever, sore throat, bruising, rash, jaundice, or unusual bleeding (eg, epistaxis).
- Instruct patient to avoid intake of alcoholic beverages or other CNS depressants (eg, pain relievers, antihistamines, sedatives) to prevent serious CNS depression.
- Emphasize importance of follow-up evaluation with health care provider to monitor progress of therapy.
- Inform patient that after discontinuation of drug, nighttime sleeping might be disturbed for a few days and increased dreaming may occur.
- Advise patient that drug may cause daytime drowsiness and to use caution while driving or performing other tasks requiring mental alertness.
- Instruct patient not to discontinue medication abruptly without consulting health care provider.
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