Pentobarbital is a medication used to manage and treat several medical conditions, including seizures, intracranial pressure control, insomnia, and as a pre-anesthetic in the operating room. This activity reviews the indications, mechanism of action, administration, adverse effects, and contraindications of pentobarbital therapy in the clinical setting. It is intended to relate the essential points needed by members of an interprofessional team managing the care of patients undergoing treatment with pentobarbital and its related conditions and sequelae.
Identify the mechanism of action of pentobarbital.
Describe the potential adverse effects of pentobarbital.
Review the appropriate monitoring for the toxicity of pentobarbital.
Explain interprofessional team strategies for improving care coordination and communication to advance the use of pentobarbital and improve outcomes.
Pentobarbitals is a drug within the barbiturate class that works primarily on the central nervous system. At low doses, indications include short-term sedatives to treat insomnia and as a pre-anesthetic for surgery. At higher doses, pentobarbitals serves as an anticonvulsant for emergent seizure control and medically induced comas. Pentobarbitals is often subject to comparison with phenobarbital, another barbiturate, in the use of refractory status epilepticus. Studies have found that pentobarbitals is superior in that it has faster brain penetration and a shorter half-life, making it the treatment of choice.
Common off-label uses are for control of intracranial pressure in patients with severe brain injuries, cerebral ischemia, and those receiving treatment for Reye syndrome. Some US states use it for capital punishment, but this remains a widely controversial topic, and some manufacturers do not allow its sale to prisons. More commonly, it is used by veterinarians for euthanasia and anesthesia.