title: The use of phenobarbitone in the management of agitation and seizures at the end of life.
abstract: This study investigated the role of phenobarbitone at the end of life by retrospective analysis of case notes. During a 3-year period, of the 748 patients who died in a 32-bed palliative care unit, 60 received phenobarbitone during the last week of life. Fifty-nine patients had advanced cancer, 16 of whom had cerebral involvement. Phenobarbitone was used to control agitation and seizures. It was administered via subcutaneous infusion at a dose of 600-2400 mg/day. The mean time from starting phenobarbitone to death was 34.1 hours. Phenobarbitone was well tolerated and effective, controlling physical and psychological agitation. No further seizures occurred. This study suggests that phenobarbitone has a useful role in the management of distressing symptoms in the last few days of life.
authors.affiliation: Department of Palliative Medicine, Royal Marsden Hospital, London, United Kingdom.
authors.forename: L C
authors.initials: LC
authors.lastname: Stirling
authors.forename: A
authors.initials: A
authors.lastname: Kurowska
authors.forename: A
authors.initials: A
authors.lastname: Tookman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010634:Phenobarbital / Q000627:therapeutic use*; D011595:Psychomotor Agitation / Q000188:drug therapy*; D012189:Retrospective Studies; D012640:Seizures / Q000188:drug therapy*; D013727:Terminal Care
chemical_list: D006993:Hypnotics and Sedatives; D010634:Phenobarbital