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Test ID PENTS Pentobarbital, Serum

Useful For

Monitoring of pentobarbital therapy treatment

Method Name

Gas Chromatography-Mass Spectrometery (GC-MS)

Reporting Name

Pentobarbital, S

Specimen Type

Serum Red

Container/Tube: Red top

Specimen Volume: 2 mL

Collection Instructions: Spin down within 2 hours of draw.

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 pentobarbital's hypnotic effects 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

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

Day(s) Performed

Tuesday

Report Available

2 days

Performing Laboratory

Mayo Medical Laboratories in Rochester

Test Classification

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

CPT Code Information

80345

G0480 (if appropriate)

NY State Approved

Yes