Drug ID: 1d00000092
Drug Name: Amobarbital
Generic Names: Amytal
Category: Anxiolytics, Sedatives And Hypnotics
Legal Status: Non Opioid Prescription only drug
Indication for Mother: Category D
There is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience or studies in humans, but potential benefits may warrant use of the drug in pregnant women despite potential risks.
Recommended Dose: Insomnia- Adults - 65 to 200 mg at bedtime.
Sedation- Adults - 30 to 50 mg twice daily or 3 times daily.
Children - 2 to 6 mg/kg/dose.
Recommended In: This medication is a barbiturate derivative, prescribed for anxiety, insomnia and induction of preanesthetic sedation. It alters cerebellar function and produces drowsiness, sedation and hypnosis.
Directions For Use: It comes as a solution for injection to be administered by a healthcare provider into the vein or large muscle and tablets as recommended by physician.
Storage: Store it at controlled room temperature (15° to 30°C), and in an airtight container. Keep away from children.
Dosage Forms: Tablet | Intravenous injection | Intramuscular injection
Side Effects: Heart - Slow heart rate, low blood pressure and fainting.
Central Nervous System - Drowsiness, agitation, confusion, headache, in coordination, CNS depression, excitement, abnormal dreams, mental disturbances, hallucinations, sleeplessness and dizziness.
Gastrointestinal - Nausea, vomiting and constipation.
Blood - Blood disorders.
Liver - Liver damage.
Respiratory - Shortness of breath, difficulty in breathing and asthma.
Miscellaneous - Hypersensitivity reactions (eg, swelling, rashes, exfoliative dermatitis), fever and injection site reactions (eg, local pain, thrombophlebitis).
In Case of Overdose: Symptoms of oral overdose may occur within 15 minutes beginning with CNS depression, absent or sluggish reflexes, under ventilation, hypotension, and hypothermia and may progress to pulmonary edema and death. Hemorrhagic blisters may develop, especially at pressure points.
In extreme overdose, all electrical activity in the brain may cease, in which case a "flat" EEG normally equated with clinical death cannot be accepted. This effect is fully reversible unless hypoxic damage occurs. Consideration should be given to the possibility of barbiturate intoxication even in situations that appear to involve trauma.
Complications such as pneumonia, pulmonary edema, cardiac arrhythmias, congestive heart failure, and renal failure may occur. Uremia may increase CNS sensitivity to barbiturates if renal function is impaired. Differential diagnosis should include hypoglycemia, head trauma, cerebrovascular accidents, convulsive states, and diabetic coma.
To obtain up-to-date information about the treatment of overdose, a good resource is your certified Regional Poison Control Center. Protect the patient's airway and support ventilation and perfusion. Meticulously monitor and maintain, within acceptable limits, the patient's vital signs, blood gases, serum electrolytes, etc. Absorption of drugs from the gastrointestinal tract may be decreased by giving activated charcoal, which, in many cases, is more effective than emesis or lavage; consider charcoal instead of or in addition to gastric emptying. Repeated doses of charcoal over time may hasten elimination of some drugs that have been absorbed. Safeguard the patient's airway when employing gastric emptying or charcoal.
Diuresis and peritoneal dialysis are of little value; hemodialysis and hemoperfusion enhance drug clearance and should be considered in serious poisoning. If the patient has chronically abused sedatives, withdrawal reactions may be manifest following acute overdose.
Avoid If: Caution should be exercised in patients with history of liver or kidney disease, any allergy, who are taking other medications, elderly, children, during pregnancy and breastfeeding.
Avoid long-term use of this medication; otherwise patient may get addicted to this drug.
Avoid rapid administration; otherwise it may lead to breathing problem.
Avoid alcohol consumption.
Contraindicated in patients with history of acute or chronic pain, respiratory disease, severe liver impairment, porphyria and hypersensitivity.
Drug Interaction: Anticoagulants - Barbiturates can induce hepatic microsomal enzymes, resulting in increased metabolism and decreased anticoagulant response of oral anticoagulants (eg, warfarin, acenocoumarol, dicumarol, and phenprocoumon). Patients stabilized on anticoagulant therapy may require dosage adjustments if barbiturates are added to or withdrawn from their dosage regimen.
Corticosteroids - Barbiturates appear to enhance the metabolism of exogenous corticosteroids, probably through the induction of hepatic microsomal enzymes. Patients stabilized on corticosteroid therapy may require dosage adjustments if barbiturates are added to or withdrawn from their dosage regimen.
Griseofulvin - It would be preferable to avoid concomitant administration of these drugs.
Doxycycline - If amobarbital sodium and doxycycline are administered concurrently, the clinical response to doxycycline should be monitored closely.
Phenytoin, Sodium Valproate, Valproic Acid - The effect of barbiturates on the metabolism of phenytoin appears to be variable. Some investigators report an accelerating effect, whereas others report no effect. Because the effect of barbiturates on the metabolism of phenytoin is not predictable, phenytoin and barbiturate blood levels should be monitored more frequently if these drugs are given concurrently. Sodium valproate and valproic acid appear to increase the amobarbital sodium serum levels; therefore, amobarbital sodium blood levels should be closely monitored and appropriate dosage adjustments made as clinically indicated.
CNS Depressants - The concomitant use of other CNS depressants, including other sedatives or hypnotics, antihistamines, tranquilizers, or alcohol, may produce additive depressant effects.
Monoamine Oxidase Inhibitors (MAOIs) - MAOIs prolong the effects of barbiturates, probably because metabolism of the barbiturate is inhibited.
Estradiol, Estrone, Progesterone, and Other Steroidal Hormones - There have been reports of patients treated with antiepileptic drugs who become pregnant while taking oral contraceptives. An alternate contraceptive method might be suggested to women taking barbiturates.