Emergency Medicine is Hard

What is phenobarbital?

• Phenobarbital is a CNS depressant that promotes binding to GABA_A receptors, modulates chloride currents through receptor channels, and inhibits glutamate-induced depolarizations
• Metabolized by the liver
• Half-life: 100 hours (~5 days)
• Loading dose: 10 mg/kg IBW IV Bolus over 30 min, administering 130-260 mg aliquots every 15-30 minutes for persistent symptoms

Benefits

• Rapid onset of action
• Fewer respiratory complications
• There is cross-tolerance between barbiturates and ethanol
• Anti-convulsant properties
• Decreases hospital and ICU LOS

Sources:

https://onlinelibrary.wiley.com/doi/full/10.1002/npr2.12347