Neurologic Drugs : Antiepileptics
IPHEN1 “Phenobarbital injection” 100 mg/ml; 1 ml/amp
OPHEN2 “Phenobarbital tablet” 30 mg/tab
適應症：癲癇。
Usual dose:
Epilepsy:
Adult:
Injection: IM, average dose, 100 to 320 mg.
Oral: 50-100 mg bid-tid.
Pediatric:
Injection: IM, In the treatment of neonatal seizures, IM loading (16.2 mg/kg) and maintenance doses (3.1 mg/kg/day of phenobarbital are suggested to produce serum levels of 20 mcg/mL. Loading doses of 20.2 mg/kg and maintenance doses of 3.8 mg/kg/day are suggested to obtain serum levels of 25 mcg/mL. However, due to wide inter-patient variation the suggested maintenance guidelines should be adjusted according to plasma concentrations and clinical effects in each individual neonate.
Oral: 15-50 mg bid-tid.
Sedation:
Adult:
Injection: IM,30 to 120 mg/day in 2 to 3 divided doses; maximum: 400 mg/day. Preoperative sedation: IM, 100 to 200 mg, 60 to 90 minutes before surgery.
Oral: daytime sedation, 30-120 mg divided into 2-3 doses; up to max. 400 mg in 24 hours. Hypnotic: 100-320 mg as a single dose; up to max. 400 mg in 24 hours.
Pediatric:
Injection: IM, Infants, Children, and Adolescents: preoperative sedation: 1 to 3 mg/kg.
Oral: 6 mg/kg/day divided into 3 doses.
Dose adjustment:
Hepatic insufficiency: barbiturates should be used cautiously in p’ts with liver function impairment, Initial doses should be reduced.
Renal failure: p’ts with severe renal failure- GFR < 10ml/min should receive Phenobarbital q12-16h.
Contraindication:
Porphyria, marked impairment of liver function, respiratory disease (dyspnea or obstruction).
Adverse effect:
Common: anxiety, nervousness, insomnia, irritability, clumsiness, unsteadiness, dizziness, lightheadedness, constipation, nausea, vomiting, drowsiness, hangover effect, headache.
Serious: agranulocytosis, megaloblastic anemia, thrombocytopenia, exfoliative dermatitis, Stevens-Johnson syndrome, hepatic damage, osteopenia or rickets, thrombophlebitis.