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Pentobarbital



Pentobarbital
Systematic (IUPAC) name
5-Ethyl-5-(1-methylbutyl)-
2,4,6(1
H,3H,5H)-pyrimidinetrione
Identifiers
CAS number 76-74-4
ATC code N05CA01
PubChem 4737
DrugBank APRD01174
Chemical data
Formula C11H18N2O3 
Mol. mass 226.1317
Pharmacokinetic data
Bioavailability 70-90% oral; 90% rectal
Protein binding 20-45%
Metabolism Hepatic
Half life 15-48 hours
Excretion Renal
Therapeutic considerations
Pregnancy cat.

D (USA)

Legal status

USA: Schedule II (oral and parenteral); Schedule III (rectal)

Routes Oral, Intravenous, Intramuscular, Rectal; also Intraperitoneal & Intracardiac (for animal euthanasia)

Pentobarbital is a short-acting barbiturate that is available as both a free acid and a sodium salt, the former of which is only slightly soluble in water and ethanol.[1] One trade name for this drug is Nembutal®, coined by Dr. John S. Lundy, who started using it in 1930, from the structural formula of the sodium salt—Na (sodium) + ethyl + methyl + butyl + al (common suffix for barbiturates).[2]

Contents

Uses

Approved

Pentobarbital's FDA approved human uses include treatment of seizures and preoperative (and other) sedation; it is also approved as a short-term hypnotic.[3]

In France, it is used in the treatment of insomnia, and as a preanesthetic.[4]

Unapproved/Investigational/Off-Label

Off-label uses of pentobarbital include reduction of intracranial pressure in Reye's syndrome, traumatic brain injury[1] and induction of coma in cerebral ischemia patients.[3]

Veterinary medicine

In veterinary medicine, sodium pentobarbital—traded under names such as Sagatal—is used as an anaesthetic.[5] Pentobarbital is an ingredient in Equithesin.

Veterinary Euthanasia

It is used by itself, or more often in combination with complementary agents such as phenytoin, in commercial animal euthanasia[6] injectable solutions. Trade names include Euthasol, Euthatal, Beuthanasia-D and Fatal Plus.

Human Euthanasia

Pentobarbital has also been used for physician-assisted suicide. Pentobarbital was used for this purpose in the Northern Territory of Australia, prior to euthanasia becoming illegal. It is also commonly used in Oregon for physician assisted suicide. [7] It is also used by Dignitas (euthanasia group) The actor George Sanders committed suicide with Nembutal in 1972

Folklore

A pentobarbital suppository was cited in an October 2006 news article in WorldNetDaily.com as the cause of death of Marilyn Monroe.

The Beatles were accused[citation needed] of writing their 1966 hit Yellow Submarine while under the psychoactive effects of Nembutal, though band members denied the allegations.

The Clash makes a reference to it in the song The Right Profile from the album London Calling in which the lyrics read "Nembutal numbs it all, But I prefer… alcohol!"

Metabolism

  Pentobarbital undergoes first-pass metabolism in the liver and possibly the intestines.[8]

Drug Interactions

Administration of alcohol, opioids, antihistamines, other sedative-hypnotics, and other central nervous system depressants will increase the sedation caused by pentobarbital.[3]



References and End Notes

  1. ^ a b Pentobarbital. San Diego Reference Laboratory: Technical Help. Retrieved on 16 July, 2005.
  2. ^ Lee C. Fosburgh (1997). "Imagining in Time: From this point in time: Some memories of my part in the history of anesthesia -- John S. Lundy, MD". American Association of Nurse Anesthetists Journal 65 (4): 323-8. PubMed.
  3. ^ a b c Deglin, Judith Hopfer; April Hazard Vallerand [1988] (2004-06-01). Davis's Drug Guide for Nurses, 9th edition, F. A. Davis Company, 789. ISBN 978-0-8036-1154-2. Retrieved on 2005-07-16. 
  4. ^ VIDAL (2001). PENTOBARBITAL SODIQUE. Banque de Données Automatisée sur les Médicaments. Retrieved on May 2, 2006.
  5. ^ UBC Committee on Animal Care (2005). Euthanasia. SOP 009E1 - euthanasia - overdose with pentobarbital. The University of British Columbia. Retrieved on 4 October, 2005.
  6. ^ Unknown (2003). ANESTHESIA AND ANALGESIA. Animal Use Protocols. University of Virginia. Retrieved on 4 October, 2005.
  7. ^ Goodenough, Patrick (2002-03-26). Campaigners Rally Round Right-To-Die Woman. CNSNews.com. Retrieved on July 22, 2006.
  8. ^ Knodell, R. G.; Spector MH, Brooks DA, Keller FX, Kyner WT. (December 1980). "Alterations in pentobarbital pharmacokinetics in response to parenteral and enteral alimentation in the rat". Gastroenterology 79 (6): 1211-6. PMID 6777235.

Carbamates: Emylcamate, Felbamate, Meprobamate -- Pyrrolidines: Brivaracetam, Levetiracetam, Nefiracetam, Seletracetam

Sulfa drugs: Acetazolamide, Ethoxzolamide, Sultiame, Zonisamide -- Propionates: Beclamide -- Aldehydes: Paraldehyde -- Bromides: Potassium bromide, Sodium bromide
  This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Pentobarbital". A list of authors is available in Wikipedia.
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