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Pentobarbital (INN, AAN, BAN, USAN) or pentobarbitone (former AAN and BAN) is a short-acting barbiturate. Pentobarbital can occur as both a free acid and as salts of elements such as sodium and calcium. The free acid is only slightly soluble in water and ethanol.
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.
In high doses, pentobarbital causes death by respiratory arrest. In the United States, the drug has been used for executions of convicted criminals. Lundbeck (one of many manufacturers) does not permit its sale to prisons or corrections departments to carry out the death penalty.
Typical applications for pentobarbital are sedative, hypnotic for short term, preanesthetic and control of convulsions in emergencies.
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 induce 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.
In the Netherlands, the standard protocol for physician-assisted suicide is to provide 9 grams of pentobarbital sodium along with sugar syrup in a 20% ethanol solution for self-administration by the patient.
The oral dosage of pentobarbital indicated for physician-assisted death in the United States states of Oregon, Washington, Vermont, and California (as of January, 2016) is typically 10 g in liquid form. This is considerably higher than the dose for the management of status epilepticus.