Adult: 100-200 mg at bedtime. As amobarbital Na: 60-200 mg at bedtime. Elderly: Reduce dose.
Parenteral Hypnotic
Adult: 65-200 mg via IM inj (should not exceed 5 mL at any single site) or IV inj (should not exceed 50 mg/min) at bedtime. Max: 1,000 mg as a single dose. Elderly: Reduce dose.
Parenteral Sedation
Adult: As amobarbital Na: 30-50 mg via IM inj (should not exceed 5 mL at any single site) or IV inj (should not exceed 50 mg/min) given 2-3 times daily. Max: 1,000 mg as a single dose. Elderly: Reduce dose. Child: 6-12 yr 65-500 mg.
Nhóm bệnh nhân đặc biệt
Debilitated patient: Reduce dose.
Suy thận
Reduce dose.
Suy gan
Reduce dose. Severe: Contraindicated.
Cách dùng
May be taken with or without food.
Hướng dẫn pha thuốc
Reconstitute 500 mg sterile powd for inj in 5 mL sterile water for inj to make a 10% IV soln. Reconstitute 500 mg sterile powd for inj in 2.5 mL of sterile water for inj to make 20% IM soln. Rotate vial to dissolve; do not shake.
Tương kỵ
Incompatible w/ acidic soln. Syringe: Thiamine.
Chống chỉ định
Dyspnoea or airway obstruction, porphyria, sleep apnoea, pre-existing CNS depression or coma. Severe hepatic impairment.
Thận trọng
Patient w/ CV disease, depression or suicidal ideation, history of drug addiction or acute alcoholism. Renal and mild to moderate hepatic impairment. Elderly and debilitated patients, childn. Pregnancy and lactation.
May impair mental or physical abilities requiring mental alertness (e.g. driving or operating machinery).
Chỉ số theo dõi
Monitor vital signs during and after admin.
Quá liều
Symptoms: CNS depression, absent or sluggish reflexes, underventilation, hypotension, hypothermia, pulmonary oedema, haemorrhagic blisters. Management: Secure airway, support ventilation and perfusion. Admin activated charcoal. Perform haemodialysis and haemoperfusion in serious cases.
Tương tác
May reduce plasma levels of oral anticoagulants (e.g. warfarin, dicoumarol, acenocoumarol, phenprocoumon), corticosteroids, griseofulvin, doxycycline, Na valproate and valproic acid. Constant monitoring of blood levels when concomitantly used w/ phenytoin. May increase CNS depressant effect w/ antihistamines, sedative/hypnotics, tranquilisers. May prolong the effect w/ MAOIs. May reduce the effect of estradiol, progesterone, estrone and other steroidal hormones.
Tương tác với thức ăn
May enhance CNS depressant effect of alcohol.
Tác dụng
Description: Mechanism of Action: Amobarbital interferes w/ the transmission of impulses from the thalamus to the cortex of the brain which develops an imbalance in central inhibitory and facilitatory mechanisms. Onset: W/in 5 min (IV). Pharmacokinetics: Absorption: Readily absorbed from the GI tract. Distribution: Rapidly distributed to all tissues and fluids; crosses the placenta; enters breast milk (small amounts). Plasma protein binding: Approx 60%. Metabolism: Undergoes hepatic metabolism via penultimate oxidation of the 3-methylbutyl substituent forming a tertiary alcohol, hydroxyamobarbital (inactive metabolite). Excretion: Via urine (approx 50% as 3'-hydroxyamylobarbital, approx 30% as N-hydroxyamylobarbital, <1% as unchanged drug); faeces (approx 5%). Half-life: Approx 40 min (1st phase); approx 20-25 hr (2nd phase).
Đặc tính
Amobarbital Source: National Center for Biotechnology Information. PubChem Database. Amobarbital, CID=2164, https://pubchem.ncbi.nlm.nih.gov/compound/Amobarbital (accessed on Jan. 20, 2020)
Amytal Sodium Injection, Powder, Lyophilized, for Solution (Marathon Pharmaceuticals, LLC). DailyMed. Source: U.S. National Library of Medicine. https://dailymed.nlm.nih.gov/dailymed/. Accessed 10/11/2014.Anon. Amobarbital. Lexicomp Online. Hudson, Ohio. Wolters Kluwer Clinical Drug Information, Inc. https://online.lexi.com. Accessed 10/11/2014.Buckingham R (ed). Amobarbital. Martindale: The Complete Drug Reference [online]. London. Pharmaceutical Press. https://www.medicinescomplete.com. Accessed 10/11/2014.McEvoy GK, Snow EK, Miller J et al (eds). Amobarbital, Amobarbital Sodium. AHFS Drug Information (AHFS DI) [online]. American Society of Health-System Pharmacists (ASHP). https://www.medicinescomplete.com. Accessed 10/11/2014.
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