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Writer's pictureMark Nguyen, PharmD, BCEMP

Phenobarbital for Severe Alcohol Withdrawal - #PHARMFAX

Phenobarbital is a great option to keep in your drug bank for severe alcohol withdrawal.

 

Phenobarbital is a great option to keep in your drug bank for severe alcohol withdrawal. The mechanism enhances GAGA agonism by prolonging opening of Cl- channels, and suppresses glutamate via NMDA receptor antagonism. Thats a two-fer that works excellent for severe alcohol withdrawal. You can give 260 mg IV as a load, then 130 mg IV PRN withdrawal symptoms, or 10 mg/kg IBW as a load. Phenobarbital is the only barbituate that has anticonvulsant properties at sub-hypnotic doses. This load would safely get you to this level without inducing respiratory failure. Some safety considerations. Phenobarbital comes in a highly alkaline base that causes extravasation; make sure to give it slowly. Should NOT be used for mild cases of alcohol withdrawal. Be mindful of benzodiazepines and other sedatives given prior and during use of phenobarbital. For more PHARMFAX in the drug bank, watch the rest of my videos on my page.


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Not medical advice. Educational purposes only. No relationships to report. I hope you learned something new.

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