Intravenous phenobarbital for alcohol withdrawal and convulsions.
In a prospective, uncontrolled study, 62 alcoholic patients received IV phenobarbital (IV-PB) to treat the alcohol withdrawal (AW) syndrome. Initially 260 mg of IV-PB were administered followed by 130 mg every 30 minutes to an end point of light sedation. A mean loading dose of 598 (+/- 192) mg of IV-PB resulted in a mean increase in the serum PB level of 13.9 (+/- 4.7) microgram/mL. Thus, the serum PB level rose 1.65 micrograms/mL for each mg/kg of IV-PB administered to these adult patients in AW. Forty-six of 48 tremulous patients (96%) showed improvement in their AW tremors. None of the 38 patients who presented with AW seizures had another convulsion during a mean observation period of three hours and 47 minutes. Transient ataxia or over-sedation occurred in three of 62 patients (5%) and was exacerbated by concurrent ethanol, diazepam, or phenytoin (six of 17), who were excluded from the study. We conclude that IV-PB is a safe and efficacious therapy for mild to moderate AWS, and IV-PB may prevent AW seizures.
D000208:Acute Disease; D000328:Adult; D000430:Alcohol Withdrawal Delirium / Q000188:drug therapy; D004341:Drug Evaluation; D000431:Ethanol / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007262:Infusions, Intravenous; D008297:Male; D010634:Phenobarbital / Q000008:administration & dosage* / Q000627:therapeutic use; D011446:Prospective Studies; D012640:Seizures / Q000188:drug therapy*; D013375:Substance Withdrawal Syndrome / Q000188:drug therapy*
D000431:Ethanol; D010634:Phenobarbital