Secobarbital

What is Secobarbital

Secobarbital is a short-acting oral barbiturate similar to pentobarbital. The parenteral and rectal formulations are no longer available in the US.

It is rarely used in the short-term treatment of insomnia for periods of up to 2 weeks. Preoperatively, secobarbital is used to relieve anxiety and induce sedation.

Compared with other barbiturates, it has the highest lipid solubility, which allows it to have a faster distribution. Secobarbital was approved by the FDA in 1950.

Brand Name

Seconal

Indications

• insomnia
• procedural sedation

Side Effects

1. agitation
2. angioedema
3. anxiety
4. apnea
5. ataxia
6. bone fractures
7. bradycardia
8. bullous rash
9. complex sleep-related behaviors
10. confusion
11. constipation
12. depression
13. diarrhea
14. dizziness
15. drowsiness
16. excitability
17. exfoliative dermatitis
18. fever
19. hallucinations
20. headache
21. hyperkinesis
22. hypotension
23. hypoventilation
24. impaired cognition
25. insomnia
26. maculopapular rash
27. megaloblastic anemia
28. memory impairment
29. miosis
30. mydriasis
31. nausea
32. neonatal abstinence syndrome
33. neonatal respiratory depression
34. nightmares
35. nystagmus
36. osteomalacia
37. osteopenia
38. physiological dependence
39. psychological dependence
40. rash
41. somnambulism
42. Stevens-Johnson syndrome
43. suicidal ideation
44. syncope
45. thrombocytopenia
46. toxic epidermal necrolysis
47. urticaria
48. vomiting
49. withdrawal

Monitoring Parameters

• CBC

Contraindications

• abrupt discontinuation
• agranulocytosis
• alcoholism
• anticoagulant therapy
• barbiturate hypersensitivity
• breast-feeding
• carbamazepine hypersensitivity
• children
• chronic obstructive pulmonary disease (COPD)
• CNS depression
• coadministration with other CNS depressants
• complex sleep-related behaviors
• depression
• driving or operating machinery
• ethanol ingestion
• geriatric
• hepatic disease
• hepatic encephalopathy
• hydantoin hypersensitivity
• infants
• labor
• mental status changes
• neonates
• obstetric delivery
• osteomalacia
• osteoporosis
• pain
• porphyria
• pregnancy
• premature neonates
• pulmonary disease
• renal failure
• renal impairment
• respiratory depression
• seizure disorder
• seizures
• sleep apnea
• status epilepticus
• substance abuse
• suicidal ideation

Interactions

• Abemaciclib
• Acetaminophen
• Acetaminophen; Aspirin, ASA; Caffeine
• Acetaminophen; Butalbital
• Acetaminophen; Butalbital; Caffeine
• Acetaminophen; Butalbital; Caffeine; Codeine
• Acetaminophen; Caffeine
• Acetaminophen; Caffeine; Dihydrocodeine
• Acetaminophen; Caffeine; Magnesium Salicylate; Phenyltoloxamine
• Acetaminophen; Caffeine; Phenyltoloxamine; Salicylamide
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Phenylephrine
• Acetaminophen; Chlorpheniramine; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Chlorpheniramine; Phenylephrine; Phenyltoloxamine
• Acetaminophen; Codeine
• Acetaminophen; Dextromethorphan
• Acetaminophen; Dextromethorphan; Doxylamine
• Acetaminophen; Dextromethorphan; Guaifenesin; Phenylephrine
• Acetaminophen; Dextromethorphan; Phenylephrine
• Acetaminophen; Dextromethorphan; Pseudoephedrine
• Acetaminophen; Dichloralphenazone; Isometheptene
• Acetaminophen; Diphenhydramine
• Acetaminophen; Guaifenesin; Phenylephrine
• Acetaminophen; Hydrocodone
• Acetaminophen; Oxycodone
• Acetaminophen; Pentazocine
• Acetaminophen; Propoxyphene
• Acetaminophen; Pseudoephedrine
• Acetaminophen; Tramadol
• Acetazolamide
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• Aldesleukin, IL-2
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• Hydrochlorothiazide, HCTZ; Triamterene
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• Hydrocodone
• Hydrocodone; Ibuprofen
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• Hydrocodone; Potassium Guaiacolsulfonate; Pseudoephedrine
• Hydrocodone; Pseudoephedrine
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