Pentobarbital

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Pentobarbital
Systematic (IUPAC) name
5-Ethyl-5-(1-methylbutyl)- 2,4,6(1H,3H,5H)-pyrimidinetrione
Identifiers
CAS number	76-74-4
ATC code	N05CA01
PubChem	4737
DrugBank	APRD01174
Chemical data
Formula	C₁₁H₁₇N₂O₃
Mol. mass	226.1317
Pharmacokinetic data
Bioavailability	?
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]

1 Uses
2 Folklore
3 Metabolism
4 Drug Interactions
5 References and End Notes
6 External links

[edit] Uses

[edit] 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]

[edit] 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]

[edit] 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.

[edit] 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.

[edit] Human Euthanasia

Pentobarbital has also been used for physician-assisted suicide. Pentobarbital was used in the Northern Territory of Australia, prior to euthanasia becoming illegal.^[7]

[edit] 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 where accused of writing their 1966 hit Yellow Submarine while indulging in the psychoactive effects of Nembutal, though band members denied the allegations.

[edit] Metabolism

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

[edit] Drug Interactions

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

Tricyclic antidepressants decrease serum levels of pentobarbital.

[edit] References and End Notes

^ ^a ^b Pentobarbital. San Diego Reference Laboratory: Technical Help. Retrieved on July 16, 2007.
^ 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.
^ ^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 July 16, 2005.
^ VIDAL (2001). PENTOBARBITAL SODIQUE. Banque de Données Automatisée sur les Médicaments. Retrieved on May 2, 2006.
^ UBC Committee on Animal Care (2005). Euthanasia. SOP 009E1 - euthanasia - overdose with pentobarbital. The University of British Columbia. Retrieved on October 4, 2007.
^ Unknown (2003). ANESTHESIA AND ANALGESIA. Animal Use Protocols. University of Virginia. Retrieved on October 4, 2007.
^ Goodenough, Patrick (2002-03-26). Campaigners Rally Round Right-To-Die Woman. CNSNews.com. Retrieved on July 22, 2006.
^ 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. PubMed.