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The Journal of Family Practice Jun 1978
Topics: Administration, Oral; Child; Humans; Phenobarbital; Seizures; Seizures, Febrile
PubMed: 660121
DOI: No ID Found -
Neurology Jul 1988Status epilepticus refractory to initial anticonvulsant therapy is a serious condition with a high morbidity and mortality. We present 50 cases with refractory status... (Comparative Study)
Comparative Study
Status epilepticus refractory to initial anticonvulsant therapy is a serious condition with a high morbidity and mortality. We present 50 cases with refractory status epilepticus (RSE) treated with very-high-dose phenobarbital (VHDPB) without reference to a predetermined maximum level or dose. Maximum serum levels ranged from 70 to 344 micrograms/ml (median, 114 micrograms/ml). VHDPB controlled seizures in all cases where no limits were imposed upon maximum dose (47/50). We found no maximum dose beyond which further doses are likely to be ineffective. Forty patients were intubated prior to VHDPB, but recovered respiratory drive and could be removed from the ventilator despite very high serum levels. This is explained by acute drug tolerance. Hypotension was unusual, related to the highest levels, and easily controlled. VHDPB has many relative advantages over other therapies presently used for RSE.
Topics: Blood Pressure; Child; Dose-Response Relationship, Drug; Humans; Injections, Intravenous; Phenobarbital; Respiration; Status Epilepticus
PubMed: 3386819
DOI: 10.1212/wnl.38.7.1035 -
Proceedings of the Society For... Dec 1956
Topics: Anticonvulsants; Humans; Phenobarbital; Primidone
PubMed: 13389516
DOI: 10.3181/00379727-93-22813 -
Science (New York, N.Y.) Jan 1978Two doses of phenobarbital were given daily for 2 weeks to infant rats fed by intragastric cannulas. The larger dose (60 milligrams per kilogram of body weight) resulted...
Two doses of phenobarbital were given daily for 2 weeks to infant rats fed by intragastric cannulas. The larger dose (60 milligrams per kilogram of body weight) resulted in decreased spontaneous activity and increased responses to novel stimuli. The smaller dose (15 milligrams per kilogram) resulted in increased spontaneous activity and also an increase of responses to novel stimuli. The larger dose produced a 12 percent reduction in brain growth, while the smaller dose was associated with a 3 percent reduction in brain growth.
Topics: Animals; Behavior, Animal; Brain; Injections, Subcutaneous; Light; Male; Motor Activity; Noise; Phenobarbital; Rats; Rats, Wistar
PubMed: 17569495
DOI: 10.1126/science.199.4324.90 -
Acta Paediatrica Japonica : Overseas... Jun 1990
Topics: Acute Disease; Humans; Inappropriate ADH Syndrome; Infant; Male; Phenobarbital
PubMed: 2239311
DOI: 10.1111/j.1442-200x.1990.tb00836.x -
DICP : the Annals of Pharmacotherapy 1989Rectal administration of antiepileptic drugs may be a useful alternative route when oral administration is not possible due to illness, surgery, or status epilepticus.... (Comparative Study)
Comparative Study
Rectal administration of antiepileptic drugs may be a useful alternative route when oral administration is not possible due to illness, surgery, or status epilepticus. Although parenteral administration often replaces oral administration in these circumstances, there is not always a desirable intravenous line available or repeated intramuscular injections may not be practical. The purpose of this study was to determine the relative bioavailability and time course of absorption of the commercially available parenteral phenobarbital sodium solution administered rectally in comparison with the same preparation given intramuscularly. Seven healthy adult volunteers were given phenobarbital 5 mg/kg intramuscularly and rectally five weeks apart. Eighteen blood samples were drawn over 288 hours. Pharmacokinetic parameters following intramuscular versus rectal administration were the following: area under the curve 5916 vs. 5253 mumol.h/L; half-life 112 vs. 113 h; time to maximum concentration 2.1 vs. 4.4 h; and maximum serum concentration 36.2 vs. 31.4 mumol/L. Mean relative bioavailability for rectal phenobarbital was 90 percent. Therefore, the parenteral phenobarbital sodium solution given rectally is well absorbed and provides a useful alternative route of administration.
Topics: Administration, Rectal; Adult; Biological Availability; Half-Life; Humans; Injections, Intramuscular; Intestinal Absorption; Male; Phenobarbital; Solutions
PubMed: 2763578
DOI: 10.1177/1060028089023007-806 -
American Journal of Veterinary Research Apr 1980Serial assays for phenobarbital were done on the blood serum, cerebrospinal fluid (CSF), and saliva from three epileptic and two clinically normal dogs that were given... (Comparative Study)
Comparative Study
Serial assays for phenobarbital were done on the blood serum, cerebrospinal fluid (CSF), and saliva from three epileptic and two clinically normal dogs that were given various oral doses of the drug. In all dogs, the three fluids showed considerable daily fluctuations of phenobarbital concentrations, even after several weeks at the same dosage. The average ratio for CSF/serum was 0.53 and 0.39 for saliva/serum. A highly significant (P less than 0.001) correlation coefficient occurred between CSF and serum (0.95) and between CSF and saliva (0.93); although in some dogs at particular dosages, the CSF and saliva were poorly correlated. Dose-related curves demonstrated a gradually increased phenobarbital concentration in the three fluids up to dosages of 9.0 mg/kg of body weight. The present study suggests that multiple serum or saliva samples should be assayed to account for daily fluctuations; saliva can be a good indicator of unbound phenobarbital concentration in CSF.
Topics: Animals; Dog Diseases; Dogs; Epilepsy; Phenobarbital; Saliva
PubMed: 7406279
DOI: No ID Found -
Polymorphism in phenobarbital: discovery of a new polymorph and crystal structure of elusive form V.Chemical Communications (Cambridge,... Mar 2016This report highlights the discovery of a new polymorph of the anticonvulsant drug phenobarbital (PB) using polymer-induced heteronucleation (PIHn) and unravelling the...
This report highlights the discovery of a new polymorph of the anticonvulsant drug phenobarbital (PB) using polymer-induced heteronucleation (PIHn) and unravelling the crystal structure of the elusive form V. Both forms are characterized by structural, thermal and VT-Raman spectroscopy methods to elucidate phase transformation behavior and shed light on stability relationships.
Topics: Animals; Crystallography, X-Ray; Humans; Hydrogen Bonding; Phenobarbital; Polymorphism, Genetic; Spectrum Analysis, Raman
PubMed: 26926048
DOI: 10.1039/c6cc00959j -
Clinical Pediatrics Jul 1999We previously reported that IQ was significantly lowered in a group of toddler-aged children randomly assigned to receive phenobarbital or placebo for febrile seizures... (Clinical Trial)
Clinical Trial Randomized Controlled Trial
We previously reported that IQ was significantly lowered in a group of toddler-aged children randomly assigned to receive phenobarbital or placebo for febrile seizures and there was no difference in the febrile seizure recurrence rate. We retested these children 3-5 years later, after they had entered school, to determine whether those effects persisted over the longer term and whether later school performance might be affected. On follow-up testing of 139 (of the original n = 217) Western Washington children who had experienced febrile seizures, we found that the phenobarbital group scored significantly lower than the placebo group on the Wide Range Achievement Test (WRAT-R) reading achievement standard score (87.6 vs 95.6; p = 0.007). There was a nonsignificant mean difference of 3.71 IQ points on the Stanford-Binet, with the phenobarbital-treated group scoring lower (102.2 vs 105.7; p = 0.09). There were five children in our sample with afebrile seizures during the 5-year period after the end of the medication trial. Two had been assigned to phenobarbital, and three had been in the placebo group. We conclude there may be a long-term adverse cognitive effect of phenobarbital on the developmental skills (language/verbal) being acquired during the period of treatment and no beneficial effect on the rate of febrile seizure recurrences or later nonfebrile seizures.
Topics: Child; Humans; Intelligence; Intelligence Tests; Male; Neurobehavioral Manifestations; Phenobarbital; Seizures, Febrile
PubMed: 10416094
DOI: 10.1177/000992289903800702 -
Drug Metabolism and Disposition: the... 1988Three-week dosing periods at one of six oral phenobarbital doses between 15 and 400 mg/day were used to achieve steady states for induction of plasma alpha 1-acid...
Three-week dosing periods at one of six oral phenobarbital doses between 15 and 400 mg/day were used to achieve steady states for induction of plasma alpha 1-acid glycoprotein concentration (AGP) in beagle dogs. In this way, the characteristics of the dose-response relationship between phenobarbital concentration and the extent of induction could be evaluated. With the 400 mg/day dose of phenobarbital, AGP increased nearly 13-fold. The response of AGP was found to depend on the square of the phenobarbital concentration. Analysis of the decay of AGP when phenobarbital dosing was discontinued showed a kinetic pattern governed by multiple rate processes. This was the result of persistence of the phenobarbital, the turnover of some metabolic precursor to AGP, and the turnover of AGP itself.
Topics: Animals; Dogs; Dose-Response Relationship, Drug; Drug Administration Schedule; Mathematics; Models, Biological; Orosomucoid; Phenobarbital
PubMed: 2903021
DOI: No ID Found