|Trade names||Nembutal, others|
|Main uses||Status epilepticus, acute agitation, short term management of trouble sleeping, surgery|
|Side effects||Sleepiness, vomiting, headache, delirium, abuse, respiratory arrest,anaphylaxis|
|By mouth, IV, IM, rectal; also intraperitoneal & intracardiac (for animal euthanasia)|
|Onset of action||< 1 min (IV), < 25 min (IM)|
|Duration of action||15 min (IV)|
|Bioavailability||70–90% (by mouth); 90% (rectal)|
|Elimination half-life||15–48 hours|
|Chemical and physical data|
|Molar mass||226.276 g·mol−1|
|3D model (JSmol)|
Pentobarbital is a medication that has been used for status epilepticus, acute agitation, short term management of trouble sleeping, surgery, and to put someone in a coma. It is used by injection into a muscle or vein. The by mouth formulation has been discontinued in the United States. Onset is within a minute when given into a vein and within 25 minutes when into a muscle. When given into a vein effects last about 15 minutes.
Common side effects include sleepiness, vomiting, and headache. Severe side effects include delirium, abuse, respiratory arrest, and anaphylaxis. Use is not recommended in pregnancy. It is in the barbiturate family of medications. It works by increasing the activity of GABA in the brain.
Pentobarbital came into medical use in the United States in 1930 by John Lundy. They were widely misused in the 1970s and known as "yellow jackets" due to their color. It is used for veterinary euthanasia and some US states for executions of criminals. The death of Marilyn Monroe in 1962 was due to an overdose of pentobarbital and chloral hydrate.
Typical applications for pentobarbital are sedative, short term hypnotic, preanesthetic, insomnia, and control of convulsions in emergencies. Abbott Pharmaceutical discontinued manufacture of their Nembutal brand of Pentobarbital capsules in 1999, largely replaced by the benzodiazepine family of drugs. Pentobarbital was also widely abused, known on the street as "yellow jackets". They were available in 50 and 100 mg yellow capsules.
It is also used as a veterinary anesthetic agent.
Pentobarbital also has an application in reducing intracranial pressure in Reye's syndrome, traumatic brain injury and induction of coma in cerebral ischemia patients. Pentobarbital-induced coma has been advocated in patients with acute liver failure refractory to mannitol.
Pentobarbital can cause death when used in high doses. It is used for euthanasia for humans as well as animals. It is also used by itself, or in combination with complementary agents such as phenytoin, in commercial animal euthanasia injectable solutions.
It is also used by mouth for physician-assisted death in the United States states of Oregon, Washington, Vermont, and California (as of January, 2016). This is considerably higher than the dose for the management of status epilepticus.
Pentobarbital has been used or considered as a substitute for other drugs traditionally used for capital punishment in the United States when they are in short supply. Such use however is illegal under Danish law, and when this was discovered, after public outcry in Danish media, Lundbeck, the owner of the drug, stopped selling it to US states that impose the death penalty. US distributors of the drug are forbidden by the owner to sell it to any customers, such as several state authorities, that practice or participate in executions of humans.
Texas began using pentobarbital for executing death-row inmates by lethal injection on July 18, 2012. The use of pentobarbital has been considered by several states, including Ohio, Arizona, Idaho, and Washington; those states made the decision to switch following shortages of pancuronium bromide, a muscle paralytic previously used as one component in a three-drug cocktail.
Pentobarbital is synthesized by methods analogous to that of amobarbital, the only difference being that the alkylation of α-ethylmalonic ester is carried out with 2-bromopentane in place of 1-bromo-3-methylbutane to give pentobarbital.
Society and culture
One brand name for this drug is Nembutal, coined by 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). Nembutal is trademarked and manufactured by the Danish pharmaceutical company Lundbeck (now produced by Akorn Pharmaceuticals) and is the only injectable form of pentobarbital approved for sale in the United States. Abbott discontinued their Nembutal brand of Pentobarbital capsules in 1999, largely replaced by the Benzodiazepine family of drugs. Abbott's Nembutal brand of Pentobarbital capsules were widely abused and were known on the streets as "yellow jackets". They were available in 50 and 100 Mg.strength yellow capsules.
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