View source for Amobarbital sodium

{{DrugProjectFormSinglePage
|authorTag={{SG}}
|genericName=Amobarbital sodium
|aOrAn=a
|drugClass=[[barbiturate]]
|indicationType=treatment
|indication=insomnia.Also it is use as a sedative and for preanesthesic purpose.
|adverseReactions=[[dizziness]], [[headache]], [[somnolence]] and [[confusion]]
|blackBoxWarningTitle=<b><span style="color:#FF0000;">TITLE</span></b>
|blackBoxWarningBody=<i><span style="color:#FF0000;">Condition Name:</span></i> (Content)
|fdaLIADAdult=The dose of amobarbital sodium must be individualized with full knowledge of its particular characteristics and recommended rate of administration. Factors of consideration are the patient’s age, weight, and condition. The maximum single dose for an adult is 1 g.

====Sedative====
*30 to 50 mg given 2 or 3 times daily.
====Insomnia====
*It is use as an Hypnotic for the short-term treatment of [[insomnia]], since it appears to lose its effectiveness for sleep induction and sleep maintenance after 2 weeks. 
*65 to 200 mg at bedtime.
====Preanesthetic====
|offLabelAdultGuideSupport=There is limited information regarding <i>Off-Label Guideline-Supported Use</i> of Amobarbital sodium in adult patients.
|offLabelAdultNoGuideSupport=There is limited information regarding <i>Off-Label Non–Guideline-Supported Use</i> of Amobarbital sodium in adult patients.
|offLabelPedGuideSupport=There is limited information regarding <i>Off-Label Guideline-Supported Use</i> of Amobarbital sodium in pediatric patients.
|offLabelPedNoGuideSupport=There is limited information regarding <i>Off-Label Non–Guideline-Supported Use</i> of Amobarbital sodium in pediatric patients.
|contraindications=*Hypersensitivity to [[barbiturates]]
*Patients with a history of manifest or latent [[porphyria]]
*Patients with marked impairment of liver function or respiratory disease in which [[dyspnea]] or obstruction is evident
|warnings=====Habit Forming==== 
*Amobarbital sodium may be habit forming. 
*Tolerance, psychological and physical dependence may occur with continued use *Patients who have psychological dependence on [[barbiturates]] may increase the dosage or decrease the dosage interval without consulting a physician and may subsequently develop a physical dependence on [[barbiturates]]. 
*In order to minimize the possibility of overdosage or the development of dependence, the prescribing and dispensing of [[sedative]]-[[hypnotic]] [[barbiturates]] should be limited to the amount required for the interval until the next appointment. 
*Abrupt cessation after prolonged use in a person who is dependent on the drug may result in [[withdrawal symptoms]], including [[delirium]], [[convulsions]], and possibly death. 
*[[Barbiturates]] should be withdrawn gradually from any patient known to be taking excessive doses over long periods of time.

====Intravenous Administration====
*Too rapid administration may cause [[respiratory depression]], [[apnea]], laryngo- spasm, or vasodilation with fall in blood pressure.

====Acute or Chronic Pain====
*Caution should be exercised when [[barbiturates]] are administered to patients with acute or chronic pain, because paradoxical excitement could be induced or important symptoms could be masked. However, the use of [[barbiturates]] as [[sedatives]] in the postoperative surgical period and as adjuncts to [[cancer]] [[chemotherapy]] is well established.

====Usage in Pregnancy==== 
*[[Barbiturates]] can cause fetal damage when administered to a pregnant woman. <br>*Retrospective, case-controlled studies have suggested a connection between the maternal consumption of [[barbiturates]] and a higher than expected incidence of fetal abnormalities. 
*[[Barbiturates]] readily cross the placental barrier and are distributed throughout fetal tissues; the highest concentrations are found in the [[placenta]], fetal liver, and [[brain]]. 
*Fetal blood levels approach maternal blood levels following parenteral administration. 
*[[Withdrawal symptoms]] occur in infants born to women who receive [[barbiturates]] throughout the last trimester of pregnancy. 
*If amobarbital sodium is used during pregnancy or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to the [[fetus]].

====Synergistic Effects====
*The concomitant use of [[alcohol]] or other CNS depressants may produce additive CNS- depressant effects.
|clinicalTrials=The following adverse reactions and their incidence were compiled from surveillance of thousands of hospitalized patients who received [[barbiturates]]. Because such patients may be less aware of certain of the milder adverse effects of [[barbiturates]], the incidence of these reactions may be somewhat higher in fully ambulatory patients.

====More than 1 in 100 Patients====
*The most common adverse reaction, estimated to occur at a rate of 1 to 3 patients per 100, is the following:
=====Nervous System=====
*[[Somnolence]]                    

====Less than 1 in 100 Patients====
*Adverse reactions estimated to occur at a rate of less than 1 in 100 patients are listed below, grouped by organ system and by decreasing order of occurrence:
=====Nervous System=====
*[[Agitation]]
*[[Confusion]]
*[[Hyperkinesia]]
*[[Ataxia]]
*CNS depression
*[[Nightmares]]
*[[Nervousness]]
*Psychiatric disturbance
*[[Hallucinations]]
*[[Insomnia]]
*[[Anxiety]]
*[[Dizziness]]
*Abnormality in thinking

=====Respiratory System=====
*[[Hypoventilation]]
*[[Apnea]]
*Postoperative atelectasis

=====Cardiovascular System=====
*[[Bradycardia]]
*[[Hypotension]]
*[[Syncope]]

=====Digestive System=====
*[[Nausea]] 
*[[Vomiting]]
*[[Constipation]]

=====Other Reported Reactions=====
*[[Headache]]
*Injection site reactions
*Hypersensitivity reactions ([[angioedema]], skin [[rashes]], [[exfoliative dermatitis]])  
*[[Fever]]
*Liver damage
*[[Megaloblastic anemia]] following chronic phenobarbital use
|drugInteractions=Most reports of clinically significant drug interactions occurring with the [[barbiturates]] have involved [[phenobarbital]]. However, the application of these data to other [[barbiturates]] appears valid and warrants serial blood level determinations of the relevant drugs when there are multiple therapies.

====Anticoagulants====
*[[Phenobarbital]] lowers the plasma levels of [[dicumarol]] and causes a decrease in [[anticoagulant]] activity as measured by the [[prothrombin time]]. 
*[[Barbiturates]] can induce hepatic microsomal enzymes, resulting in increased metabolism and decreased [[anticoagulant]] response of oral anticoagulants (eg, [[warfarin]], [[acenocoumarol]], [[dicumarol]], and [[phenprocoumon]]). 
*Patients stabilized on [[anticoagulant]] therapy may require dosage adjustments if [[barbiturates]] are added to or withdrawn from their dosage regimen.

=====Corticosteroids===== 
*[[Barbiturates]] appear to enhance the metabolism of exogenous [[corticosteroids]], probably through the induction of hepatic microsomal enzymes. 
*Patients stabilized on [[corticosteroid]] therapy may require dosage adjustments if [[barbiturates]] are added to or withdrawn from their dosage regimen.

=====Griseofulvin=====
*[[Phenobarbital]] appears to interfere with the absorption of orally administered [[griseofulvin]], thus decreasing its blood level. 
*The effect of the resultant decreased blood levels of [[griseofulvin]] on therapeutic response has not been established. However, it would be preferable to avoid concomitant administration of these drugs.

=====Doxycycline=====
*[[Phenobarbital]] has been shown to shorten the half-life of [[doxycycline]] for as long as 2 weeks after [[barbiturate]] therapy is discontinued. 
*This mechanism is probably through the induction of hepatic microsomal enzymes that metabolize the [[antibiotic]]. 
*If amobarbital sodium and [[doxycycline]] are administered concurrently, the clinical response to [[doxycycline]] should be monitored closely.
=====Phenytoin, Sodium Valproate, Valproic Acid=====
*The effect of [[barbiturates]] on the metabolism of [[phenytoin]] appears to be variable. 
*Some investigators report an accelerating effect, whereas others report no effect. Because the effect of [[barbiturates]] on the metabolism of [[phenytoin]] is not predictable, [[phenytoin]] and [[barbiturate]] blood levels should be monitored more frequently if these drugs are given concurrently. 
*[[Sodium valproate]] and [[valproic acid]] appear to increase the amobarbital sodium serum levels; therefore, amobarbital sodium blood levels should be closely monitored and appropriate dosage adjustments made as clinically indicated.

=====CNS Depressants=====
*The concomitant use of other CNS depressants, including other [[sedatives]] or [[hypnotics]], [[antihistamines]], [[tranquilizers]], or [[alcohol]], may produce additive depressant effects.
=====Monoamine Oxidase Inhibitors (MAOIs)=====
*[[MAOIs]] prolong the effects of [[barbiturates]], probably because metabolism of the [[barbiturate]] is inhibited.

=====Estradiol, Estrone, Progesterone, and Other Steroidal Hormones=====
*Pretreatment with or concurrent administration of [[phenobarbital]] may decrease the effect of [[estradiol]] by increasing its metabolism. 
*There have been reports of patients treated with [[antiepileptic]] drugs (eg, [[phenobarbital]]) who become pregnant while taking oral contraceptives. 
*An alternate contraceptive method might be suggested to women taking [[barbiturates]].
|FDAPregCat=D
|useInPregnancyFDA=*[[Barbiturates]] can cause fetal damage when administered to a pregnant woman. <br>*Retrospective, case-controlled studies have suggested a connection between the maternal consumption of [[barbiturates]] and a higher than expected incidence of fetal abnormalities. 
*[[Barbiturates]] readily cross the placental barrier and are distributed throughout fetal tissues; the highest concentrations are found in the [[placenta]], fetal liver, and [[brain]]. 
*Fetal blood levels approach maternal blood levels following parenteral administration. 
*[[Withdrawal symptoms]] occur in infants born to women who receive [[barbiturates]] throughout the last trimester of pregnancy. 
*If amobarbital sodium is used during pregnancy or if the patient becomes pregnant while taking this drug, the patient should be apprised of the potential hazard to the fetus.

======Nonteratogenic Effects======
*Reports of infants suffering from long-term [[barbiturate]] exposure in utero included the acute [[withdrawal syndrome]] of [[seizures]] and [[hyperirritability]] from birth to a delayed onset of up to 14 days
|AUSPregCat=C
|useInLaborDelivery=*[[Hypnotic]] doses of [[barbiturates]] do not appear to impair uterine activity significantly during labor. 
*Full anesthetic doses of [[barbiturates]] decrease the force and frequency of uterine contractions. 
*Administration of sedative-hypnotic [[barbiturates]] to the mother during labor may result in respiratory depression in the newborn. 
*Premature infants are particularly susceptible to the depressant effects of [[barbiturates]]. 
*If [[barbiturates]] are used during labor and delivery, resuscitation equipment should be available.
*Data are not available to evaluate the effect of [[barbiturates]] when [[forceps]] delivery or other intervention is necessary or to determine the effect of [[barbiturates]] on the later growth, development, and functional maturation of the child.
|useInNursing=*Caution should be exercised when amobarbital sodium is administered to a nursing woman because small amounts of [[barbiturates]] are excreted in the milk.
|useInPed=*Safety and effectiveness have not been established in children below the age of 6 years.
*Children, [[barbiturates]] repeatedly produce excitement rather than [[depression]].
|useInGeri=*Elderly or debilitated patients may react to [[barbiturates]] with marked [[excitement]], [[depression]], or [[confusion]].
|useInHepaticImpair=*[[Barbiturates]] should be administered with caution and initially in reduced doses. 
*[[Barbiturates]] should not be administered to patients showing the premonitory signs of [[hepatic coma]].
|administration=====Intramuscular Use====
*[[Intramuscular]] injection of the sodium salts of [[barbiturates]] should be made deeply into a large muscle. 
*The average [[intramuscular]] dose ranges from 65 mg to 0.5 g. 
*A volume of 5 mL (irrespective of concentration) should not be exceeded at any one site because of possible tissue irritation. 
*Twenty percent solutions may be used so that a small volume can contain a large dose. 
*After [[IM]] injection of a [[hypnotic]] dose, the patient’s vital signs should be monitored. 
*Superficial intramuscular or subcutaneous injections may be painful and may produce sterile abscesses or sloughs.

====Intravenous Use====
*[[Intravenous]] injection is restricted to conditions in which other routes are not feasible, either because the patient is unconscious (as in [[cerebral hemorrhage]], [[eclampsia]], or [[status epilepticus]]), because the patient resists (as in [[delirium]]), or because prompt action is imperative. 
*Slow IV injection is essential, and patients should be carefully observed during administration. 
*This requires that [[blood pressure]], [[respiration]], and cardiac function be maintained, vital signs be recorded and equipment for resuscitation and artificial ventilation be available. 
*The rate of [[IV]] injection for adults should not exceed 50 mg/min to prevent sleep or sudden respiratory depression. 
*The final dosage is determined to a great extent by the patient’s reaction to the slow administration of the drug.
|monitoring=*After [[IM]] injection of a hypnotic dose, the patient’s vital signs should be monitored.
*Prolonged therapy with [[barbiturates]] should be accompanied by periodic evaluation of organ systems, including [[hematopoietic]], [[renal]], and [[hepatic]] systems
|IVCompat=*Solutions of amobarbital sodium should be made up aseptically with Sterile Water for Injection. 
*The accompanying table will aid in preparing solutions of various concentrations. 
*Ordinarily, a 10% solution is used. 
*After Sterile Water for Injection is added, the vial should be rotated to facilitate solution of the powder. 
*Do not shake the vial.
*Several minutes may be required for the drug to dissolve completely, but under no circumstances should a solution be injected if it has not become absolutely clear within 5 minutes. Also, a solution that forms a precipitate after clearing should not be used. 
*Amobarbital sodium hydrolyzes in solution or on exposure to air. 
*Not more than 30 minutes should elapse from the time the vial is opened until its contents are injected. 
*Prior to administration, parenteral drug products should be inspected visually for particulate matter and discoloration whenever solution containers permit.

[[File:Amobarbital IV.png|none|450px]]
|overdose=*The toxic dose of [[barbiturates]] varies considerably. 
*In general, an oral dose of 1 g of most [[barbiturates]] produces serious poisoning in an adult. 
*Toxic effects and fatalities have occurred following overdoses of amobarbital sodium alone and in combination with other CNS depressants. 
*Death commonly occurs after 2 to 10 g of ingested [[barbiturate]]. 
*The sedated, therapeutic blood levels of amobarbital range between 2 to 10 mcg/mL; the usual lethal blood level ranges from 40 to 80 mcg/mL. 
*Barbiturate intoxication may be confused with alcoholism, bromide intoxication, and various neurologic disorders. 
*Potential tolerance must be considered when evaluating significance of dose and plasma concentration.

====Signs and Symptoms====
*Symptoms of oral overdose may occur within 15 minutes beginning with CNS depression, absent or sluggish reflexes, underventilation, [[hypotension]], and [[hypothermia]] and may progress to [[pulmonary edema]] and death. 
*Hemorrhagic blisters may develop, especially at pressure points.
*In extreme overdose, all electrical activity in the brain may cease, in which case a “flat” EEG normally equated with clinical death cannot be accepted. 
*This effect is fully reversible unless hypoxic damage occurs. 
*Consideration should be given to the possibility of [[barbiturate]] intoxication even in situations that appear to involve trauma.
*Complications such as [[pneumonia]], [[pulmonary edema]], [[cardiac arrhythmias]], [[congestive heart failure]], and [[renal failure]] may occur. 
*[[Uremia]] may increase CNS sensitivity to [[barbiturates]] if renal function is impaired. 
*Differential diagnosis should include [[hypoglycemia]], head trauma, [[cerebrovascular accidents]], [[convulsive states]], and [[diabetic coma]].

====Treatment====
*To obtain up-to-date information about the treatment of overdose, a good resource is your certified Regional Poison Control Center. 
*In managing overdosage, consider the possibility of multiple drug overdoses, interaction among drugs, and unusual drug kinetics in your patient.
*Protect the patient’s airway and support ventilation and perfusion. *Meticulously monitor and maintain, within acceptable limits, the patient’s vital signs, blood gases, serum electrolytes, etc. 
*Absorption of drugs from the gastrointestinal tract may be decreased by giving activated [[charcoal]], which, in many cases, is more effective than emesis or lavage; consider [[charcoal]] instead of or in addition to gastric emptying. *Repeated doses of charcoal over time may hasten elimination of some drugs that have been absorbed. 
*Safeguard the patient’s airway when employing gastric emptying or [[charcoal]].
*[[Diuresis]] and [[peritoneal dialysis]] are of little value; [[hemodialysis]] and [[hemoperfusion]] enhance drug clearance and should be considered in serious poisoning. 
*If the patient has chronically abused sedatives, withdrawal reactions may be manifest following acute overdose.
|drugBox={{Drugbox
| Watchedfields = changed
| verifiedrevid = 464364523
| IUPAC_name = 5-ethyl-5-(3-methylbutyl)-1,3-diazinane-2,4,6-trione
| image = Amobarbital chemical structure.png

<!--Clinical data-->
| tradename =  
| Drugs.com = {{drugs.com|CONS|amobarbital}}
| pregnancy_category = ?
| legal_CA = Schedule IV
| legal_US =  
| legal_status = [[Controlled Substances Act#Schedule II controlled substances|Schedule II]]/[[Controlled Substances Act#Schedule III controlled substances|Schedule III]] (US)
| routes_of_administration = Oral, [[Intramuscular injection|IM]], [[Intravenous therapy|IV]], Rectal

<!--Pharmacokinetic data-->
| bioavailability = ?
| metabolism = [[Hepatic]]
| elimination_half-life = 8–42 hours
| excretion = [[Renal]]

<!--Identifiers-->
| CASNo_Ref = {{cascite|correct|CAS}}
| CAS_number_Ref = {{cascite|correct|??}}
| CAS_number = 57-43-2
| CAS_supplemental = 64-43-7 (sodium salt)
| ATC_prefix = N05
| ATC_suffix = CA02
| ATC_supplemental =  
| PubChem = 2164
| DrugBank_Ref = {{drugbankcite|correct|drugbank}}
| DrugBank = DB01351
| ChemSpiderID_Ref = {{chemspidercite|correct|chemspider}}
| ChemSpiderID = 2079
| UNII_Ref = {{fdacite|correct|FDA}}
| UNII = GWH6IJ239E
| KEGG_Ref = {{keggcite|correct|kegg}}
| KEGG = D00555
| ChEBI_Ref = {{ebicite|correct|EBI}}
| ChEBI = 2673
| ChEMBL_Ref = {{ebicite|correct|EBI}}
| ChEMBL = 267894

<!--Chemical data-->
| C=11 | H=18 | N=2 | O=3 
| molecular_weight = 226.272
| smiles = O=C1NC(=O)NC(=O)C1(CCC(C)C)CC
| InChI = 1/C11H18N2O3/c1-4-11(6-5-7(2)3)8(14)12-10(16)13-9(11)15/h7H,4-6H2,1-3H3,(H2,12,13,14,15,16)
| InChIKey = VIROVYVQCGLCII-UHFFFAOYAO
| StdInChI_Ref = {{stdinchicite|correct|chemspider}}
| StdInChI = 1S/C11H18N2O3/c1-4-11(6-5-7(2)3)8(14)12-10(16)13-9(11)15/h7H,4-6H2,1-3H3,(H2,12,13,14,15,16)
| StdInChIKey_Ref = {{stdinchicite|correct|chemspider}}
| StdInChIKey = VIROVYVQCGLCII-UHFFFAOYSA-N
}}
|mechAction=*[[Barbiturates]] are capable of producing all levels of CNS mood alteration, from [[excitation]] to mild [[sedation]], [[hypnosis]], and deep [[coma]]. 
*Overdosage can produce death. 
*In high enough therapeutic doses, [[barbiturates]] induce [[anesthesia]].
*[[Barbiturates]] depress the [[sensory cortex]], decrease motor activity, alter [[cerebellar]] function, and produce [[drowsiness]], [[sedation]], and [[hypnosis]].
*[[Barbiturate]]-induced sleep differs from physiologic sleep. 
*Sleep laboratory studies have demonstrated that [[barbiturates]] reduce the amount of time spent in the [[rapid eye movement]] ([[REM]]) phase of sleep or the dreaming stage. 
*Also, Stages III and IV sleep are decreased. 
*Following abrupt cessation of [[barbiturates]] used regularly, patients may experience markedly increased dreaming, nightmares, and/or [[insomnia]]. Therefore, withdrawal of a single therapeutic dose over 5 or 6 days has been recommended to lessen the [[REM]] rebound and disturbed sleep that contribute to the drug [[withdrawal syndrome]] (for example, the dose should be decreased from 3 to 2 doses/day for 1 week).
*In studies, [[secobarbital sodium]] and [[pentobarbital]] sodium have been found to lose most of their effectiveness for both inducing and maintaining sleep by the end of 2 weeks of continued drug administration, even with the use of multiple doses. 
*As with [[secobarbital sodium]] and [[pentobarbital sodium]], other [[barbiturates]] (including amobarbital) might be expected to lose their effectiveness for inducing and maintaining sleep after about 2 weeks. 
*The short-, intermediate-, and to a lesser degree, long-acting [[barbiturates]] have been widely prescribed for treating [[insomnia]]. Although the clinical literature abounds with claims that the short-acting [[barbiturates]] are superior for producing sleep whereas the intermediate-acting compounds are more effective in maintaining sleep, controlled studies have failed to demonstrate these differential effects. Therefore, as sleep medications, the [[barbiturates]] are of limited value beyond short-term use.
*[[Barbiturates]] have little analgesic action at subanesthetic doses. Rather, in subanesthetic doses, these drugs may increase the reaction to painful stimuli. 
*All [[barbiturates]] exhibit [[anticonvulsant]] activity in [[anesthetic]] doses. However, of the drugs in this class, only [[phenobarbital]], [[mephobarbital]], and [[metharbital]] are effective as oral [[anticonvulsants]] in subhypnotic doses.
*[[Barbiturates]] are respiratory depressants, and the degree of respiratory depression is dependent upon the dose. 
*With [[hypnotic]] doses, respiratory depression produced by [[barbiturates]] is similar to that which occurs during physiologic sleep and is accompanied by a slight decrease in blood pressure and heart rate.
*Studies in laboratory animals have shown that [[barbiturates]] cause reduction in the tone and contractility of the [[uterus]], [[ureters]], and [[urinary bladder]]. However, concentrations of the drugs required to produce this effect in humans are not reached with [[sedative]]-[[hypnotic]] doses.
|structure=*Amobarbital sodium is a white, friable, granular powder that is odorless, has a bitter taste, and is hygroscopic. 
*It is very soluble in water, soluble in alcohol, and practically insoluble in ether and [[chloroform]]. Amobarbital sodium is sodium 5-ethyl-5-isopentylbarbiturate and has the empirical formula C11H17N2NaO3Its molecular weight is 248.26.

It has the following structural formula:

[[File:Amobarbital.png|none|450px]]
|PK=*[[Barbiturates]] are absorbed in varying degrees following oral or parenteral administration. 
*The salts are more rapidly absorbed than are the acids. 
*The rate of absorption is increased if the sodium salt is ingested as a dilute solution or taken on an empty stomach.
*The onset of action for oral administration of [[barbiturates]] varies from 20 to 60 minutes. 
*For [[intramuscular]] ([[IM]]) administration, the onset of action is slightly faster. 
*Following [[intravenous]] ([[IV]]) administration, the onset of action ranges from almost immediately for [[pentobarbital sodium]] to 5 minutes for [[phenobarbital sodium]]. 
*Maximal CNS depression may not occur until 15 minutes or more after IV administration for [[phenobarbital sodium]]. 
*Duration of action, which is related to the rate at which the [[barbiturates]] are redistributed throughout the body, varies among persons and in the same person from time to time. 
*Amobarbital sodium, an intermediate-acting barbiturate, is a CNS depressant. *For the oral form, the onset of [[sedative]] and [[hypnotic]] action is 3/4 to 1 hour, with a duration of action ranging from 6 to 8 hours. 
*These values should serve as a guide but not be used to predict exact duration of effect. 
*No studies have demonstrated that the different routes of administration are equivalent with respect to bioavailability.
*[[Barbiturates]] are weak acids that are absorbed and rapidly distributed to all tissues and fluids, with high concentrations in the [[brain]], [[liver]], and [[kidneys]]. 
*Lipid solubility of the [[barbiturates]] is the dominant factor in their distribution within the body. 
*The more lipid soluble the [[barbiturate]], the more rapidly it penetrates all tissues of the body. 
*[[Barbiturates]] are bound to plasma and tissue proteins to a varying degree, with the degree of binding increasing directly as a function of lipid solubility.
*[[Phenobarbital]] has the lowest lipid solubility, lowest plasma binding, lowest brain protein binding, the longest delay in onset of activity, and the longest duration of action. 
*At the opposite extreme is [[secobarbital]], which has the highest lipid solubility, highest plasma protein binding, highest brain protein binding, the shortest delay in onset of activity, and the shortest duration of action. *Amobarbital sodium is classified as an intermediate [[barbiturate]]. 
*The plasma half-life for amobarbital sodium in adults ranges between 16 and 40 hours, with a mean of 25 hours.
*[[Barbiturates]] are metabolized primarily by the hepatic microsomal enzyme system, and the metabolic products are excreted in the urine and, less commonly, in the feces. 
*Only a negligible amount of amobarbital sodium is eliminated unchanged in the urine.
|nonClinToxic=====Carcinogenesis====
=====Animal Data=====
[[Phenobarbital sodium]] is [[carcinogenic]] in mice and rats after lifetime adminis- tration. In mice, it produced benign and malignant liver cell tumors. In rats, benign liver cell tumors were observed very late in life.
=====Human Data=====
In a 29-year epidemiologic study of 9,136 patients who were treated on an anticonvulsant protocol that included [[phenobarbital]], results indicated a higher than normal incidence of [[hepatic carcinoma]]. Previously, some of these patients had been treated with thorotrast, a drug that is known to produce [[hepatic carcinomas]]. Thus, this study did not provide sufficient evidence that [[phenobarbital sodium]] is [[carcinogenic]] in humans.
A retrospective study of 84 children with brain tumors matched to 73 normal controls and 78 cancer controls (malignant disease other than brain tumors) suggested an association between exposure to [[barbiturates]] prenatally and an increased incidence of [[brain tumors]].
|howSupplied=*Amobarbital sodium Vials 0.5 g (dry powder) are available as follows:
1 UNIT-PACK NDC 42998-303-01
|storage=*Store at 59° to 86°F (15° to 30°C).
|packLabel=[[File:Amobarbital FDA label.png|none|500px]]
|fdaPatientInfo='''The following information should be given to patients receiving barbiturates.'''
*The use of [[barbiturates]] carries with it an associated risk of psychological and/or physical dependence.
*[[Barbiturates]] may impair the mental and/or physical abilities required for the performance of potentially hazardous tasks, such as driving a car or operating machinery. 
*The patient should be cautioned accordingly.
*[[Alcohol]] should not be consumed while taking [[barbiturates]]. 
*The concurrent use of the [[barbiturates]] with other CNS depressants (eg, [[alcohol]], [[narcotics]], [[tranquilizers]], and [[antihistamines]]) may result in additional CNS-depressant effects.
|alcohol=*[[Alcohol]] should not be consumed while taking [[barbiturates]]. The concurrent use of the [[barbiturates]] with other CNS depressants (eg, [[alcohol]], [[narcotics]], [[tranquilizers]], and [[antihistamines]]) may result in additional CNS-depressant effects.
|brandNames=*Amytal<ref>{{cite web|url=http://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=0a6ebd81-8112-425e-aefd-d5506dbfd93c|title=AMYTAL SODIUM- amobarbital sodium injection, powder, lyophilized, for solution }} </ref>
}}
{{LabelImage
|fileName=Amobarbital package.png
}}