Indications of Berdinal 200 mg/ml
Berdinal 200 mg/ml is indicated for the following conditions:
Hypnotics for the short-term treatment of insomnia
Long-term anticonvulsants for the treatment of generalized tonic-clonic and cortical local seizures. And, in the emergency control of certain acute convulsive episodes, (those associated with status epilepticus, eclampsia meningitis, tetanus, and toxic reactions to Strychnine or local anesthetics).
Adjunct anti-epileptic drugs, Barbiturates
Berdinal 200 mg/ml is a long-acting barbiturate. It depresses the sensory cortex, reduces motor activity, changes cerebellar function and produces drowsiness, sedation and hypnosis. Its anticonvulsant property is exhibited at high doses.Berdinal 200 mg/ml acts on GABAA receptors, increasing synaptic inhibition. This has the effect of elevating seizure threshold and reducing the spread of seizure activity from a seizure focus. Berdinal 200 mg/ml may also inhibit calcium channels, resulting in a decrease in excitatory transmitter release. The sedative-hypnotic effects of Berdinal 200 mg/ml are likely the result of its effect on the polysynaptic midbrain reticular formation, which controls CNS arousal.
Dosage of Berdinal 200 mg/ml
Suggested doses of Berdinal 200 mg/ml for specific indications are as follows:Pediatric Oral Dosage:
Preoperative: 1 mg to 3 mg/kg.
Anticonvulsant: 1 mg to 6 mg/kg per day
Adult Oral Dosage:
Daytime sedative: 30 mg to 120 mg daily in 2 to 3 divided doses.
Bedtime hypnotic: 100 mg to 320 mg.
Anticonvulsant: 50 mg to 100 mg 2 to 3 times daily.
Pediatric Injection Dosage:
15 to 20 mg/kg IV over 10 to 15 min.
Preoperative Sedation:1 to 3 mg/kg IM/IV;
Anticonvulsant: 4 to 6 mg/kg IM/IV per day, for 10 days. Alternatively, use 10 to 15 mg/kg IM/IV per day to reach therapeutic level more quickly. Maxium IV rate 60 mg/min.
Adult Injection Dosage:
Insomnia: 100 to 320 mg IM/IV;
Convulsions: 100 to 320 mg IV. Repeat if needed (maximum, 600 mg per day);
Status Epilepticus: 10 to 20 mg/kg IV. Repeat if needed.
Administration of Berdinal 200 mg/ml
May be taken with or without food.
Interaction of Berdinal 200 mg/ml
The concomitant use of Alcohol or other CNS depressants may produce additive CNS depressant effects.
Berdinal 200 mg/ml is contraindicated in patients with known Berdinal 200 mg/ml sensitivity or a history of latent porphyria.
Side Effects of Berdinal 200 mg/ml
The most common adverse reaction is somnolence. Other less frequent adverse reactions are agitation, confusion, hyperkinesia, ataxia, CNS depression, nightmares, nervousness, psychiatric disturbance, hallucinations, insomnia, anxiety, dizziness, thinking abnormality, apnea, bradycardia, hypotension, nausea, vomiting and constipation.
Pregnancy & Lactation
Pregnancy Category D. Berdinal 200 mg/ml can cause potential fetal damage. Their use in pregnancy alone, or in combination with other anticonvulsants, can cause coagulation defects in the newborn infant which may be preventable by the prophylactic administration of Vitamin K to the mother prior to delivery. Berdinal 200 mg/ml is excreted through human milk; so caution should be taken during lactation period.
Precautions & Warnings
Tolerance and psychological and physical dependence may occur with continuing use. Berdinal 200 mg/ml should be administered with caution to patients who are mentally depressed, have suicidal tendencies, or a history of drug abuse. In patients with hepatic damage, Berdinal 200 mg/ml should be administered with caution and initially reduced doses.
Overdose Effects of Berdinal 200 mg/ml
The toxic dose of barbiturates varies considerably. In general, an oral dose of 1 gram of most barbiturates produces serious poisoning in an adult. Death commonly occurs after 2 to 10 grams of ingested barbiturate. Acute overdosage with barbiturates is manifested by CNS and respiratory depression Treatment of overdosage is mainly supportive and immediate hospitalization is necessary.
Keep below 30°C temperature, away from light & moisture. Keep out of the reach of children.
Dilute with most IV infusion soln (e.g. NaCl 0.45% or 0.9%, lactated Ringer's, dextrose 5%, Ringer's).
Adjunct anti-epileptic drugs, Barbiturates
Mode Of Action
Berdinal 200 mg/ml, the longest-acting barbiturate, is used for its anticonvulsant and sedative-hypnotic properties in the management of all seizure disorders except absence (petit mal). Berdinal 200 mg/ml acts on GABAA receptors, increasing synaptic inhibition. This has the effect of elevating seizure threshold and reducing the spread of seizure activity from a seizure focus. Berdinal 200 mg/ml may also inhibit calcium channels, resulting in a decrease in excitatory transmitter release. The sedative-hypnotic effects of Berdinal 200 mg/ml are likely the result of its effect on the polysynaptic midbrain reticular formation, which controls CNS arousal.
Pregnancy Category D. Berdinal 200 mg/ml can cause fetal damage when administered to a pregnant woman. If this drug is used during pregnancy, or if the patient becomes pregnant while taking this drug, the patient should be in risk of the potential hazard to the fetus. Caution should be taken when Berdinal 200 mg/ml is administered to a nursing woman since small amounts of Berdinal 200 mg/ml are excreted in the milk.