Home Drug Guide Butabarbital Sodium

Drug Guide

Generic Name

Butabarbital Sodium

Brand Names Butisol Sodium, Sarisol No. 1, Sarisol No. 2, Sarisol, Buticaps, Butabarbital, Butabarb, Butalan

Classification

Therapeutic: Sedative and hypnotic for short-term use

Pharmacological: Barbiturate

FDA Approved Indications

  • Short-term treatment of insomnia
  • Preoperative sedation

Mechanism of Action

Butabarbital enhances the activity of gamma-aminobutyric acid (GABA) at GABA-A receptor sites, leading to sedative, hypnotic, and anxiolytic effects.

Dosage and Administration

Adult: Typically 50-100 mg at bedtime; maximum dose varies by physician discretion.

Pediatric: Use is generally not recommended in children due to safety concerns.

Geriatric: Dose adjustments may be necessary; start low and titrate carefully, considering increased sensitivity to sedatives.

Renal Impairment: Use with caution; adjustments may be needed based on renal function.

Hepatic Impairment: Use with caution; hepatic metabolism may be affected and increase sedation.

Pharmacokinetics

Absorption: Well absorbed orally.

Distribution: Widely distributed; crosses the blood-brain barrier.

Metabolism: Hepatic metabolism via hepatic enzymes.

Excretion: Renal excretion of metabolites.

Half Life: Approximately 100-250 hours, varies with individual and duration of use.

Contraindications

  • Allergy to barbiturates
  • Porphyria

Precautions

  • History of substance abuse
  • Respiratory depression
  • Hepatic impairment
  • Renal impairment
  • Use with caution in elderly and debilitated patients

Adverse Reactions - Common

  • Drowsiness (Common)
  • Dizziness (Common)
  • Headache (Sometimes)

Adverse Reactions - Serious

  • Respiratory depression (Rare)
  • Hypersensitivity reactions (Rare)
  • Addiction potential and tolerance (Significant with prolonged use)

Drug-Drug Interactions

  • Other CNS depressants (opioids, benzodiazepines)
  • Alcohol
  • Cimetidine
  • MAOIs

Drug-Food Interactions

N/A

Drug-Herb Interactions

N/A

Nursing Implications

Assessment: Monitor respiratory status, level of consciousness, and liver/renal function.

Diagnoses:

  • Risk for injury due to sedation or dizziness
  • Ineffective airway clearance

Implementation: Administer dose as prescribed; monitor for adverse effects; educate patient about sedation risks.

Evaluation: Assess effectiveness in improving sleep or sedation needs, monitor for adverse effects.

Patient/Family Teaching

  • Take medication exactly as prescribed.
  • Avoid alcohol and other CNS depressants.
  • Warn about potential drowsiness and impaired ability to perform tasks requiring alertness.
  • Do not stop abruptly after long-term use—doctors should advise on tapering.

Special Considerations

Black Box Warnings:

  • Potential for addiction, physical and psychological dependence

Genetic Factors: Genetic variations in enzyme metabolism may affect drug levels.

Lab Test Interference: None noted.

Overdose Management

Signs/Symptoms: Respiratory depression, coma, pinpoint pupils, hypotension, decreased reflexes.

Treatment: Supportive care including airway management, oxygen, IV fluids, gastric lavage, activated charcoal if recent ingestion; reversal with possibly **flumazenil** is ineffective in barbiturate overdose.

Storage and Handling

Storage: Store at room temperature, away from light and moisture.

Stability: Stable under recommended conditions.

🛡️ 5 Critical Medication Safety Tips for Nurses

1

Triple-Check High-Risk Medications

Always have another nurse verify insulin, heparin, warfarin, and chemotherapy drugs. These "high-alert" medications cause the most serious errors. Check concentration, dose calculation, and pump settings twice.

2

Know Look-Alike, Sound-Alike Drugs

Common mix-ups: hydromorphone/morphine, Celebrex/Celexa, Zyprexa/Zyrtec. Always use BOTH generic and brand names, read labels twice, and use barcode scanning when available. One wrong letter can be fatal.

3

Assess Before AND After Giving Meds

Check vitals before cardiac meds, pain levels before analgesics, and blood glucose before insulin. Always reassess within 30 minutes to evaluate effectiveness and watch for adverse reactions.

4

Watch for Drug Interactions

Common dangerous combinations: warfarin + aspirin (bleeding), ACE inhibitors + potassium (hyperkalemia), digoxin + diuretics (toxicity). Always check drug interactions before administering new medications.

5

Educate Your Patients

Teach patients medication names, purposes, major side effects, and what to report. Informed patients catch errors and improve compliance. Always encourage questions - an educated patient is a safer patient.

⚡ Remember: When in doubt, don't give it out! It's always safer to double-check than regret later.

⚠️ Medical Disclaimer

This drug guide is for educational purposes only and is NOT intended for clinical use. Always consult current prescribing information, healthcare providers, and institutional protocols before administering any medication. Do not use this information for patient care decisions.