Barbit Injection

✔️ Common Side Effects

• Nausea
• Diarrhea
• Hyperactivity
• Depression
• Confusion
• Decreased blood pressure
• Fatigue
• Dizziness and sleepiness (avoid driving)

✔️ Pharmacology

• Mechanism: Suppresses sensory cortex, decreases motor activity, alters cerebellar function. Increases synaptic inhibition via GABAA receptors, raising seizure threshold and reducing seizure activity spread. Potentially inhibits calcium channels, decreasing excitatory transmitter release.

✔️

Adult Dose

• Status Epilepticus: 200-600 mg IV; or 15-18 mg/kg IV loading dose at 25-60 mg/min, repeat PRN (max 30 mg/kg).
• Hypnotic: 100-320 mg.
• Preoperative Sedation: 100-200 mg IM 60-90 min pre-op.

Child Dose

• Status Epilepticus: 100-400 mg IV; or 15-20 mg/kg IV at ≤2 mg/kg/min (max 1000 mg/dose).
• Seizures:
  • Neonates: 3-5 mg/kg/day IV/PO 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

• Adjustment: Reduce dose for renal impairment. Severe cases are contraindicated.

✔️ Administration

• Reconstitution: Dilute with IV solutions (e.g., NaCl 0.45% or 0.9%, lactated Ringer's, dextrose 5%, Ringer's).
• IV Administration: Slow injection at <60 mg/min.
• IM Administration: Inject into a large muscle.

✔️ Interactions

• Interacts with acetaminophen, anticoagulants, MAOIs, antidepressants, asthma, cold, allergy treatments, sedatives, steroids, tranquilizers, and vitamins. Increases drowsiness when combined with these drugs.

✔️ Contraindications

Acute intermittent porphyria, barbiturate hypersensitivity.

✔️ Pregnancy & Lactation

• Category D: Potential fetal damage. May cause coagulation defects in newborns, preventable with Vitamin K.
• Excreted in breast milk; use caution.

✔️ Precautions & Warnings

• Potential for addiction with long-term use.
• Avoid use for more than two weeks for insomnia.
• Use caution in patients with depression, liver damage, suicidal thoughts, or a history of drug abuse.

✔️ Storage Conditions

• Store below 30°C, away from light and moisture. Keep out of reach of children.