Nembutal Pentobarbital sodium IV Vial injection is a short-acting barbiturate, chemically designated as sodium 5-ethyl-5-(1-methylbutyl) barbiturate. This is one of the reasons for being more suitable for suicide than longer-acting barbiturates such as phenobarbital.
Nembutal is a proven, reliable drug that brings about a peaceful death. Almost no failures are known, despite large statistics (for example, the Swiss euthanasia organization Dignitas reported 840 exits with no single failure). There are however reports on seemingly slow or painful deaths with Nembutal in capital punishment, although this may be due to poor quality of the drug from compounding pharmacies given intravenously rather than orally.
PACK SIZES AND CONTENTS OF NEMBUTAL INJECTION:
Nembutal Injection has available in sizes of 20ml, 50ml, 100ml, and 250ml at our Nembutal Shop. Each ml contains pentobarbital sodium 50 mg,100 mg, or 250 mg (lethal dose) in a vehicle of approximately propylene glycol, 40%, alcohol, 10% and water for injection, to volume. The range of actual pentobarbital sodium in a vial may vary between 3 g to 15 g, although 6 g seems common. The containers come in a clear vial typical for sterile solutions and should have an untouched protective metal cap if unopened, and be labeled clearly with a due date. The Nembutal solution may be taken intravenously, for very quick effect as in capital punishment, or orally.
DOSAGE AND ADMINISTRATION:
Dosages of barbiturates must be individualized with full knowledge of their particular characteristics and recommended rate of administration. Factors of consideration are the patient’s age, weight, and condition. Parenteral routes should be used only when oral administration is impossible or impractical.
- Intramuscular Administration. IM injection of the sodium salts of barbiturates should be made deeply into a large muscle, and a volume of 5 mL should not be exceeded at any one site because of possible tissue irritation. After IM injection of a hypnotic dose, the patient’s vital signs should be monitored. The usual adult dosage of NEMBUTAL (pentobarbital) Sodium Solution is 150 to 200 mg as a single IM injection; the recommended pediatric dosage ranges from 2 to 6 mg/kg as a single IM injection not to exceed 100 mg.
- Anticonvulsant use. In convulsive states, the dosage of Nembutal Pentobarbital sodium injection should be kept to a minimum to avoid compounding the depression which may follow convulsions. The injection must be made slowly with due regard to the time required for the drug to penetrate the blood-brain barrier.
- Special patient population. Dosage should be reduced in the elderly or debilitated because these patients may be more sensitive to barbiturates. Dosage should be reduced for patients with impaired renal function or hepatic disease.
- Inspection. Parenteral drug products should be inspected visually for particulate matter and discoloration prior to administration, whenever solution containers permit. Solutions for injection showing evidence of precipitation should not be used.
POTENTIATING THE COCKTAIL AND MASKING THE TASTE
- It is usually recommended to drink some alcohol immediately after (not prior) to the Nembutal ingestion to potentiate its effect and mask the very bitter taste.
- Eating a big meal prior to or after the drug ingestion is not recommended to reduce the chances of slow drug absorption or vomiting. Dignitas offers clients chocolates to deal with the bitter taste of the drug.
TIME TO DEATH
Experience in the world has learned that after injecting 50 grams of either or lethal dose pentobarbital or secobarbital; death generally occurs within two hours maximum.
The following adverse reactions and their incidence were compiled from the surveillance of thousands of hospitalized patients. Because such patients may be less aware of certain of the milder adverse effects of barbiturates; the incidence of these reactions may be somewhat higher in fully ambulatory patients.
More than 1 in 100 patients. The most common adverse reaction estimated to occur at a rate of 1 to 3 patients per 100 is the Nervous System: Somnolence.
Less than 1 in 100 patients. Adverse reactions estimated to occur at a rate of less than 1 in 100 patients listed below:
- Nervous system: Agitation, confusion, hyperkinesia, ataxia, CNS depression, nightmares, nervousness, psychiatric disturbance, hallucinations, insomnia, anxiety, dizziness, thinking abnormality.
- Respiratory system: Hypoventilation, apnea.
- Cardiovascular system: Bradycardia, hypotension, syncope.
- Digestive system: Nausea, vomiting, constipation.
- Other reported reactions: Headache, injection site reactions, hypersensitivity reactions (angioedema, skin rashes, exfoliative dermatitis), fever, liver damage, megaloblastic anemia following chronic phenobarbital use.
A pentobarbital overdose is an amount taken in excess of that which is medically recommended. Two to ten grams of excess can cause death. In extreme overdose, all electrical activity in the brain may cease, in which case a “flat” EEG normally equated with clinical death cannot be accepted. This effect is fully reversible unless hypoxic damage occurs. Consideration should be given to the possibility of barbiturate intoxication even in situations that appear to involve trauma.
Complications such as pneumonia, pulmonary edema, cardiac arrhythmias, congestive heart failure, and renal failure may occur. Uremia may increase CNS sensitivity to barbiturates. Differential diagnosis should include hypoglycemia, head trauma, cerebrovascular accidents, convulsive states, and diabetic coma.