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Psychotropic Use during Pregnancy
Published in “Bert” Bertis Britt Little, Drugs and Pregnancy, 2022
Phenobarbital is a barbiturate used to treat seizure disorders. In the past this drug was used for mild anxiety or sedation, but it is now rarely used for that purpose today. Administration of phenobarbital is usually via the oral route, but it may be given parenterally if necessary.
Sedative and Hypnotic Drugs
Published in Sahab Uddin, Rashid Mamunur, Advances in Neuropharmacology, 2020
Arup Kumar Misra, Pramod Kumar Sharma
Phenobarbital, long-acting barbiturates is used epilepsy. Barbiturates perform its epileptic activity by rapidly reduce the depolarizing CNS neurons by enhancing its depressing activity on GABAergic transmission and also block the excitatory transmission by acting on AMPA glutamate receptor. Phenobarbital, long-acting barbiturates is used for the management of focal and tonic-clonic seizures with least side effects (Brodie and Kwan, 2012).
The Two-Step Concept of Intestinal Carcinogenesis
Published in Herman Autrup, Gary M. Williams, Experimental Colon Carcinogenesis, 2019
Norman D. Nigro, Arthur W. Bull
Rat liver is one of the organ systems in which multistage tumorigenesis has been described. Studies by Peraino have shown that phenobarbital given orally is a tumor promoter in rats initiated with 2-acetylaminofluorene.8 The enhancing effect is dependent on the length of time phenobarbital is fed. There are two other systems in which carcinogenesis has been enhanced by exposure to chemicals after treatment of the animal with an initiating agent. Intraperitoneal injections of butylated hydroxytoluene (BHT) were shown to increase cell proliferation and lung adenomas in mice previously treated with urethane.9 Saccharin and dl-tryptophan have been shown to increase bladder tumors in both dogs and rats, when given after the carcinogen.10 The remainder of this report will deal with the phenomenon of initiation and promotion as it applies to the intestinal tract.
The effect of acidic beverage versus mineral water on the change in serum phenobarbital concentrations: a randomized clinical trial on children with seizure
Published in International Journal of Neuroscience, 2021
Morteza Tavasolizadeh, Kazem Hasanpour, Milad Nazarzadeh, Davood Mahdian, Omid Gholami
Phenobarbital, the eldest modern anti-epileptic medication discovered in 1912, is a derivation of barbituric acid that increase binding to inhibitory gamma-aminobutyric acid receptors. It also inhibits glutamate induced depolarizations and regulate chloride currents through receptor channels [1]. One of the most common antiepileptic drugs used in neonates and children is phenobarbital [2]. One of the most important determination for oral bioavailability of drugs is absorption [3] and Phenobarbital has a weak acidity nature (pH at which the drug is 50% ionized (pKa) = 7.3). Absorption of a drug is influenced by the ionization state of drug, and ionization process is depends on the pH of the environment [4]. In an unionized state, permeability through the lipid bilayers of the intestinal mucosa is higher [4]. Based on Henderson–Hasselbalch equation, weak acidic drugs are predominantly in the unionized state and will thereby permeate more readily [4]. Therefore, based on the previous pharmacokinetics evidence, we hypothesized that intake of Phenobarbital with an acidic beverage such as Orange juice may increase Phenobarbital oral absorption.
Pharmacotherapeutic management of acute alcohol withdrawal syndrome in critically Ill patients
Published in Expert Opinion on Pharmacotherapy, 2020
A. Glahn, P. J. Proskynitopoulos, S. Bleich, T. Hillemacher
Phenobarbital is a barbiturate that binds to the neural GABA-A receptors. It is used in the treatment of epileptic seizures and also regarded as a potent hypnotic drug [29]. In our review, we identified two observational retrospective studies that evaluated the used of phenobarbital. In one study, 94% of 122 patients with AWS had a significant improvement during phenobarbital therapy while no patient had to receive intensive care [30,31]. In another study on 86 AWS patients treated mainly with phenobarbital, the authors concluded that it could be regarded as an alternative to BDZ therapy, although they did not compare phenobarbital use to sole BDZ use [31]. Phenobarbital was compared to BDZs in three retrospective cohort studies. Tidwell et al. (2018) examined 60 patients receiving phenobarbital and 60 that were treated according to the CIWA-Ar protocol. Patients in the phenobarbital group had a significantly shorter length of stay and were less frequently requiring invasive ventilation. Also, the average lorazepam dosage was significantly lower [26]. In another study where the authors compared 36 patients treated with phenobarbital to 36 treated with lorazepam, the average length of stay was not significantly different while the CIWA-Ar score (from baseline to 24 h) was significantly lower [32]. In a more extensive retrospective study comparing 143 patients treated with phenobarbital to 419 patients treated with BDZs the authors conclude that phenobarbital is an effective alternative as both primary and secondary treatment outcomes were similar in both groups [33].
Current strategies for managing intestinal failure-associated liver disease
Published in Expert Opinion on Drug Safety, 2021
Jordan D Secor, Lumeng Yu, Savas Tsikis, Scott Fligor, Mark Puder, Kathleen M Gura
Phenobarbital is an anti-epileptic agent that has been used to treat IFALD [18]. In treating IFALD, phenobarbital is believed to work by augmenting both bile salt-independent and -dependent biliary flow and increasing the Na-K-APTase enzymes involved in bile flow [19]. Phenobarbital is a constitutive androstane receptor (CAR) agonist. CAR, in turn, modulates hepatic phase I/II detoxification enzymes and alternative excretory pumps that play a role in regulating toxic biliary accumulation [19]. In several murine studies, phenobarbital reduced intrahepatic cholestasis induced by the secondary bile acid lithocholic acid. Phenobarbital potentiated CAR-dependent prevention of multifocal hepatic necrosis and nuclear translocation of anti-apoptotic protein Mcl-1 [20,21]