Abstract
Phenobarbital is an effective and safe anticonvulsant drug introduced in clinical use in 1904. Its mechanism of action is the synaptic inhibition through an action on GABAA. The loading dose of phenobarbital is 20 mg/kg intravenously and the maintenance dose is 3 to 4 mg/kg by mouth. The serum concentration of phenobarbital is up to 40 g/ml. Nonresponders should receive additional doses of 5 to 10 mg/kg until seizures stop. Infants with refractory seizures may have a serum concentration of phenobarbital of 100 g/ml. Phenobarbital is metabolized in the liver by CYP2C9 with minor metabolism by CYP2C19 and CYP2E1. A quarter of the dose of phenobarbital is excreted unchanged in the urine. In adults, the half-life of phenobarbital is 100 hours and in term and preterm infants is 103 and 141 hours, respectively. The half-life of phenobarbital decreases 4.6 hours per day and it is 67 hours in infants 4 week old.
Keywords: Dosing, metabolism, neonate, pharmacokinetics, phenobarbital, serum-levels.
Current Pediatric Reviews
Title:Clinical Pharmacology of Phenobarbital in Neonates: Effects, Metabolism and Pharmacokinetics
Volume: 12 Issue: 1
Author(s): Gian M. Pacifici
Affiliation:
Keywords: Dosing, metabolism, neonate, pharmacokinetics, phenobarbital, serum-levels.
Abstract: Phenobarbital is an effective and safe anticonvulsant drug introduced in clinical use in 1904. Its mechanism of action is the synaptic inhibition through an action on GABAA. The loading dose of phenobarbital is 20 mg/kg intravenously and the maintenance dose is 3 to 4 mg/kg by mouth. The serum concentration of phenobarbital is up to 40 g/ml. Nonresponders should receive additional doses of 5 to 10 mg/kg until seizures stop. Infants with refractory seizures may have a serum concentration of phenobarbital of 100 g/ml. Phenobarbital is metabolized in the liver by CYP2C9 with minor metabolism by CYP2C19 and CYP2E1. A quarter of the dose of phenobarbital is excreted unchanged in the urine. In adults, the half-life of phenobarbital is 100 hours and in term and preterm infants is 103 and 141 hours, respectively. The half-life of phenobarbital decreases 4.6 hours per day and it is 67 hours in infants 4 week old.
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Cite this article as:
Pacifici M. Gian, Clinical Pharmacology of Phenobarbital in Neonates: Effects, Metabolism and Pharmacokinetics, Current Pediatric Reviews 2016; 12 (1) . https://dx.doi.org/10.2174/1573397111666151026223914
DOI https://dx.doi.org/10.2174/1573397111666151026223914 |
Print ISSN 1573-3963 |
Publisher Name Bentham Science Publisher |
Online ISSN 1875-6336 |
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