We describe, the first case of phenobarbital-induced DRESS syndrome presenting as a lichenoid eruption.A 49-year-old man had received phenobarbital for a cerebral metastasis. Twenty-five days later, he developed a purplish skin eruption, odynophagia, oral mucosal erosion and fever. Physical examination revealed a cervical lymphadenopathy and facial edema associated to a diffuse violaceous maculo-papular itchy rash. Laboratory findings showed a 1200/mm3 eosinophil’s cell count. Alanine aminotransferase was 169 IU/l. Lactate dehydrogenase and creatinine phosphokinase were at 768 and 90 IU/l, respectively. All symptoms resolved completely five weeks after phenobarbital withdrawal. Few days later, the patient died because of a cardio-respiratory arrest.

There are several reports about the effects of postnatal Phenobarbital on intraventricular hemorrhage. This study is carried out to determine the effect of Phenobarbital on prevention of IVH in preterm infants.In NICU Ghaem Hospital all infants with a birth weight< 1500grams, gestational age< 34 weeks and with a postnatal age less than 12 hs who did not required mechanical ventilation enrolled and randomly assigned to Phenobarbital and control group.Infants in treated group received two loading dose of 10mg/kg/dose of Phenobarbital 12 hours appears, followed by a maintenance dose of 2.5mg/kg every 12 hours for 6 days. Serial brain sonographies were obtained on day 1-3, repeated between day 4-7, and between day 8 until discharge on all of infants.58 infants < 1500 grams and gestational age< 34 weeks randomly were divided Phenobarbital group (n=26) and control group (N=32). Ten infants (17.2%) developed IVH, which three (11.5%) patients were in Phenobarbital group and seven (21.9%) were in control group, this difference is not significant (p=0.248). There is also no difference in severity of IVH between two groups (p=0.476).This study showed no significant effect of Phenobarbital on prevention or severity of IVH and further studies are needed to recommend Phenobarbital for routine use.

Background. Phenobarbital consists of different polymorphic forms such as (I), (II) and (III) forms. Every polymorph has certain shape and habit, that may change it's physical characteristics. The physical attributes must be considered for the formulation and manufacturing processes.Methods. In this study a Phenobarbital tablet made by pharmaceutics department laboratory of Isfahan faculty of pharmacy (coded U) were compared with four commercial products made by three Iranian companies (Coded A, D, P) and an American company (coded L). Various tests such as: disintegration time, hardness, weight variation, dissolution rate and content uniformity were carried out.Results. Obtained results were in order of: P>L>U>A>D for disintegration time; A>U>D>L>P for hardness; D>U>L>A>P for weigth variation; D>L>U>A>P for dissolution. Melting point of three polymorphic forms of phenobarbital powder were in order of I>II>III.Discussion. Content uniformity were in acceptable range for all samples. In addition, samples A. D and P were consisted of Polymorphs (I) and (II). Sample U, however, was consisted of pohymorph (II).

Objectives: Phenobarbital (PB) is the most widely used antiepileptic drug in the world, but its possible deleterious cognitive and behavioral side effects remain and important concern among physicians and patients. We attempt to investigate whether discontinuation of PB in epileptic children was accompanied by improvement in cognitive function.Design and methods: Evaluation of neuropsychiatric performance was performed by Wechsler intelligence Scale for Children-Revised (WISC-R), in 2 consecutive periods of 7 months interval, in 2 groups of epileptic children between 6-12 years old who were seizure free for at least 2 year and who were taking only PB as antiepileptic drug. The case group consisted of 24 patients for whom PB was discontinued and the control group consisted of 21 children who continued to take PB.Results: Results indicated that discontinuation of PB improved total IQ scored compared to control group (p=0.027), and this increase was mostly in performance (nonverbal) items while verbal items remained almost unchanged.Conclusion: These findings suggest that PB affects cognitive function; and the performance (nonverbal) deficits are reversible after therapy discontinuation.

Phenobarbital is still one of the most commonly used medical treatments for different types of seizures. It has numerous different side-effects. Antiepileptic hypersensitivity syndrome (AHS) is a rare and potentially life-threatening adverse reaction to aromatic anticonvulsants such as phenobarbital. Its characteristic features are fever, rash, and lymphadenopathy with different severity of hematologic abnormalities. This case report presents a 26-month-old girl that developed fever, disseminated maculopapular rash, petechiae and thrombocytopenia two weeks after the initiation of phenobarbital prescribed for febrile seizure prophylaxis. The patient was admitted in our center with the impression of hypersensitivity syndrome, so phenobarbital was discontinued and her treatment was resumed with methylprednisolone and intravenous immunoglobulin. After a few days, all symptoms improved and the platelet count was normalized. Thrombocytopenia is a rare complication of hypersensitivity syndrome to phenobarbital in children. Paying attention to this point can prevent the life-threatening adverse effects of this highly consumed medicine.

The ever-increasing sensitivity of humans and living in a world full of stress and anxiety have led to the increased consumption of painkillers and sleeping pills. Barbiturates, which are among the most important sedatives, are regularly used by ordinary people. Addiction, suicide, and accidental deaths from inappropriate use of these drugs have been a subject of constant concern in medicine [1, 2]. Phenobarbital was the first effective antiepileptic drug introduced in 1912 [3]. It is a barbiturate that slows down the activities of the brain and nervous system and is used as a sedative in the treatment or prevention of seizures and in short-term therapies. Phenobarbital is used in all types of absence epilepsy and continuous epileptic seizures. Injectable phenobarbital is used for the emergency treatment of some acute seizures, including the attacks with eclampsia, meningitis, and toxic reactions to strychnine. It is also used for the prevention and treatment of febrile seizures [4]...

Phenobarbital is a drug of barbiturates class that it’s Anticonvulsant and sedative effects has been caused it’s widely. Usage in nervous system diseases espicially epilepsy. The epileptic pregnant women who taking this drug maybe bear neonates with congenital malformation e.g:hypoplasia or occasionally aplasia of finger - and toenails and distal phalanges, cleft lip, cleft palate and cardiac malformation. Phenytoin is another antiepileptic drugs that teratogenic effects was better known than the phenobarbital as a “Fetal Hydantoin Syndrome”. This report was focused on the infant whose epileptic mother’s consumed phenobarbital during pregnancy. The infant had palatine and labial cleft associated with low set ears, ear deformity, ocular hypertelorism, broad nasal bridge, short neck. Most of this anomallies was seen in Fetal Hydantoin syndrome.