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Passionflower | ||
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Dehydroepiandrosterone (DHEA) | ||
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| Pronunciation |
 (me
foe BAR bi
tal) |
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| U.S. Brand Names |
| Mebaral® |
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| Generic Available |
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No |
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| Synonyms |
| Methylphenobarbital |
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| Pharmacological Index |
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Barbiturate |
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| Use |
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Sedative; treatment of grand mal and petit mal epilepsy |
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| Restrictions |
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C-IV |
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| Pregnancy Risk Factor |
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D |
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| Contraindications |
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Hypersensitivity to mephobarbital, other barbiturates, or any component; pre-existing CNS depression; respiratory depression; severe uncontrolled pain; history of porphyria |
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| Adverse Reactions |
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>10%: Central nervous system: Dizziness, lightheadedness, drowsiness, "hangover" effect 1% to 10%: Central nervous system: Confusion, mental depression, unusual excitement, nervousness, faint feeling, headache, insomnia, nightmares Gastrointestinal: Constipation, nausea, vomiting |
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| Drug Interactions |
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CYP2C, 2C8, and 2C19 enzyme substrate |
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| Mechanism of Action |
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Increases seizure threshold in the motor cortex; depresses monosynaptic and polysynaptic transmission in the CNS |
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| Pharmacodynamics/Kinetics |
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Onset of action: 20-60 minutes Duration: 6-8 hours Absorption: Oral: ~50% Serum half-life: 34 hours |
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| Usual Dosage |
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Oral: Children: 6-12 mg/kg/day in 2-4 divided doses Adults: 200-600 mg/day in 2-4 divided doses Sedation: Children: <5 years: 16-32 mg 3-4 times/day >5 years: 32-64 mg 3-4 times/day Adults: 32-100 mg 3-4 times/day Dosing adjustment in renal or hepatic impairment: Use with caution and reduce dosages |
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| Dietary Considerations |
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High doses of pyridoxine may decrease drug effect; barbiturates may increase the metabolism of vitamin D & K; dietary requirements of vitamin D, K, C, B12, folate and calcium may be increased with long-term use |
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| Mental Health: Effects on Mental Status |
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Dizziness and drowsiness are common; may cause confusion, nervousness, depression, nightmares, or insomnia; may rarely cause hallucinations |
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| Mental Health: Effects on Psychiatric Treatment |
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May rarely cause agranulocytosis; use caution with clozapine and carbamazepine; may induce hepatic enzymes resulting in an increase or decrease effect of concurrent psychotropic; monitor to altered response |
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| Dental Health: Local Anesthetic/Vasoconstrictor Precautions |
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No information available to require special precautions |
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| Dental Health: Effects on Dental Treatment |
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No effects or complications reported |
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| Patient Information |
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May cause drowsiness, may impair coordination and judgment; do not discontinue abruptly; notify physician of dark urine, pale stools, jaundice, abdominal pain, persistent nausea, and vomiting; do not skip doses |
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| Nursing Implications |
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High doses of pyridoxine may decrease drug effect |
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| Dosage Forms |
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Tablet: 32 mg, 50 mg, 100 mg |
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| References |
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Pond SM, Olson KR, Osterloh JD, et al, "Randomized Study of the Treatment of Phenobarbital Overdose With Repeated Doses of Activated Charcoal," JAMA, 1984, 251(23):3104-8. Zawada ET, Nappi J, Done G, et al, "Advances in the Hemodialysis Management of Phenobarbital Overdose," South Med J, 1983, 76(1):6-8. |
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