Barbiturates on the NCLEX
Phenobarbital and the barbiturate class: respiratory depression, narrow therapeutic index, withdrawal.
Barbiturates are mostly historical for general use; phenobarbital still used in seizures. NCLEX tests respiratory depression and withdrawal seizures.
Common drugs
Phenobarbital (seizures, alcohol withdrawal), pentobarbital (rare), thiopental (anesthesia induction, mostly replaced).
Side effects
Respiratory depression. Sedation. Tolerance and dependence. CYP450 induction (many drug interactions).
Withdrawal
Seizures possible. Slow taper required.
Overdose
No specific antidote (unlike benzos). Supportive care, urinary alkalinization for phenobarbital.
Frequently asked
Why barbiturates rarely used?
Narrow therapeutic index. Higher overdose mortality than benzos. Benzos generally safer.
Phenobarbital level?
15-40 mcg/mL therapeutic for seizures.
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