Pentobarbital

Pentobarbital is a short-acting barbiturate that is available as both a free acid and a sodium salt, the former of which is only slightly soluble in water and ethanol.^[1] One trade name for this drug is Nembutal®, coined by Dr. John S. Lundy, who started using it in 1930, from the structural formula of the sodium salt—Na (sodium) + ethyl + methyl + butyl + al (common suffix for barbiturates).^[2]

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Uses

Approved

Pentobarbital's FDA approved human uses include treatment of seizures and preoperative (and other) sedation; it is also approved as a short-term hypnotic.^[3]

In France, it is used in the treatment of insomnia, and as a preanesthetic.^[4]

Unapproved/Investigational/Off-Label

Off-label uses of pentobarbital include reduction of intracranial pressure in Reye's syndrome, traumatic brain injury^[1] and induction of coma in cerebral ischemia patients.^[3]

Veterinary medicine

In veterinary medicine, sodium pentobarbital—traded under names such as Sagatal—is used as an anaesthetic.^[5] Pentobarbital is an ingredient in Equithesin.

Veterinary Euthanasia

It is used by itself, or more often in combination with complementary agents such as phenytoin, in commercial animal euthanasia^[6] injectable solutions. Trade names include Euthasol, Euthatal, Beuthanasia-D and Fatal Plus.

Human Euthanasia

Pentobarbital has also been used for physician-assisted suicide. Pentobarbital was used for this purpose in the Northern Territory of Australia, prior to euthanasia becoming illegal. It is also commonly used in Oregon for physician assisted suicide. ^[7] It is also used by Dignitas (euthanasia group) The actor George Sanders committed suicide with Nembutal in 1972

Folklore

A pentobarbital suppository was cited in an October 2006 news article in WorldNetDaily.com as the cause of death of Marilyn Monroe.

The Beatles were accused^{[citation needed]} of writing their 1966 hit Yellow Submarine while under the psychoactive effects of Nembutal, though band members denied the allegations.

The Clash makes a reference to it in the song The Right Profile from the album London Calling in which the lyrics read "Nembutal numbs it all, But I prefer… alcohol!"

Metabolism

  Pentobarbital undergoes first-pass metabolism in the liver and possibly the intestines.^[8]

Drug Interactions

Administration of alcohol, opioids, antihistamines, other sedative-hypnotics, and other central nervous system depressants will increase the sedation caused by pentobarbital.^[3]

References and End Notes

Carbamates: Emylcamate, Felbamate, Meprobamate -- Pyrrolidines: Brivaracetam, Levetiracetam, Nefiracetam, Seletracetam