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Test ID PENTS Pentobarbital, Serum


Specimen Required


Collection Container/Tube: Red top (Serum gel/SST are not acceptable)

Submission Container/Tube: Plastic vial

Specimen Volume: 1.2 mL

Collection Instructions:

1. Draw blood immediately before next scheduled dose.

2. Centrifuge and aliquot serum in plastic vial within 2 hours of collection.


Forms

If not ordering electronically, complete, print, and send a Therapeutics Test Request (T831) with the specimen.

Useful For

Monitoring of pentobarbital therapy treatment

Method Name

Gas Chromatography-Mass Spectrometry (GC-MS)

Reporting Name

Pentobarbital, S

Specimen Type

Serum Red

Specimen Minimum Volume

0.7 mL

Specimen Stability Information

Specimen Type Temperature Time
Serum Red Refrigerated (preferred) 14 days
  Ambient  14 days
  Frozen  14 days

Clinical Information

Pentobarbital is a short-acting barbiturate with anticonvulsant and sedative-hypnotic properties. Uses include sedation induction; relief of preoperative anxiety; control of status epilepticus or seizures resulting from meningitis, tetanus, alcohol withdrawal, poisons, chorea, or eclampsia; and induction of coma in the management of cerebral ischemia and increased intracranial pressure that may follow stroke or head trauma.(1,2)

 

Pentobarbital is administered orally, parenterally, and rectally. The duration of hypnotic effect is about 1 to 4 hours. The drug distributes throughout the body with about 35% to 45% of a dose bound to plasma proteins in the blood. Metabolism takes place in the liver via oxidation to the inactive metabolite, hydroxypentobarbital. Elimination is biphasic; half-life is about 4 hours in the first phase, and 35 to 50 hours in the second phase. Excretion occurs through the urine, mainly as glucuronide conjugates of metabolites, with only about 1% excreted as unchanged drug.(1,2) Tolerance to the hypnotic effects of pentobarbital occurs after about 2 weeks of continuous dosing.

Reference Values

Therapeutic range

Hypnotic: 1-5 mcg/mL

Therapeutic coma: 20-50 mcg/mL

Reducing intracranial pressure: 30-40 mcg/mL

This degree of sedation requires artificial respiratory support.

Toxic concentration: >10 mcg/mL

Cautions

The concentration at which toxicity occurs varies and results should be interpreted in light of clinical situation.

 

Specimens collected in serum gel tubes are not acceptable because the drug can absorb on the gel and lead to falsely decreased concentrations.

Day(s) Performed

Wednesday

Report Available

3 to 9 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

80345

G0480 (if appropriate)

NY State Approved

Yes