Phenobarbitone

Phenobarbitone is a barbiturate, primarily used as an anticonvulsant and sedative. It acts by depressing the central nervous system, leading to sedation and control of seizures.

Indications

-Treatment of epilepsy (generalized and partial seizures) -Sedation and anxiety relief -Management of withdrawal symptoms in neonates

Dosage

-Adults: 60-180 mg/day in divided doses or as a single dose at bedtime. -Children: 1-6 mg/kg/day in divided doses. -Neonates: Initial loading dose of 15-20 mg/kg, followed by maintenance doses of 3-4 mg/kg/day.

Contra-Indications

-Hypersensitivity to Phenobarbitone or other barbiturates -Severe respiratory insufficiency -Porphyria -Severe liver impairment

Special Precautions

-Monitor for signs of abuse and dependency -Use with caution in patients with respiratory diseases, liver impairment, or kidney dysfunction -Gradually taper off to avoid withdrawal symptoms -Avoid abrupt discontinuation -Not recommended during pregnancy or breastfeeding unless absolutely necessary

Side Effects

-Drowsiness -Dizziness -Ataxia -Cognitive impairment -Respiratory depression -Hypotension -Rash -Dependency and withdrawal symptoms

Drug Interactions

-Enhanced CNS depression with alcohol, benzodiazepines, and other CNS depressants -Reduced efficacy of oral contraceptives, warfarin, and corticosteroids due to enzyme induction -Increased metabolism and reduced efficacy of other anticonvulsants (e.g., phenytoin, carbamazepine)