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Evading Seizures: Phenobarbital Reintroduced as a Multifunctional Approach to End-of-Life Care
Helen Senderovich1,2, Sarah Waicus3, Keisa Mokenela4
1Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada.
Case Reports in Oncology
|April 18, 2022
Summary
Phenobarbital effectively manages seizures and agitation in end-of-life care. This case study shows its utility in palliative care when other routes are unavailable.
Area of Science:
- Palliative Care
- Neurology
- Pharmacology
Background:
- Evaluating phenobarbital's role in end-of-life (EOL) care.
- Phenobarbital is effective for EOL seizures and agitation, adaptable to various administration routes and palliative care (PC) settings.
Observation:
- A 90-year-old female with glioblastoma experienced escalating seizures.
- Oral and IV access were lost, making phenytoin unviable.
- Subcutaneous phenobarbital was initiated and titrated to 60 mg/day for seizure control.
Findings:
- Subcutaneous phenobarbital provided adequate seizure control.
- No serious adverse skin reactions were observed.
- Phenobarbital did not hasten death at therapeutic doses.
Implications:
- Phenobarbital is a viable option for seizure management in EOL settings, especially when other routes fail.
- Its sedative effects can enhance patient comfort during the EOL phase.
- Demonstrates the practical application of phenobarbital in long-term care palliative units.
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