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Barbiturates

Barbiturates. Tintinalli Chapter 163. Sedative – Hypnotic Crosses blood – brain – barrier Depresses activity in nerve and muscle tissue Enhances GABA Common uses Anticonvulsant Conscious sedation Alcohol withdrawal High abuse potential. Barbiturates. Ultrashort acting to Long acting

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Barbiturates

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  1. Barbiturates Tintinalli Chapter 163

  2. Sedative – Hypnotic Crosses blood – brain – barrier Depresses activity in nerve and muscle tissue Enhances GABA Common uses Anticonvulsant Conscious sedation Alcohol withdrawal High abuse potential Barbiturates

  3. Ultrashort acting to Long acting Absorption Stomach and small intestine Clearance Mostly hepatic Some renal (longer acting) Pharmacology

  4. High similar to alcohol Drowsiness Dis-inhibition Ataxia Slurred speech Mental confusion Vitals Hypothermia Respiratory depression Hypotension Clinical Features

  5. GI motility slowed Pupils variable DTR variable Clinical Features

  6. Supportive care Airway Volume expansion Gastric emptying Forced diuresis Especially phenobarb Urinary alkalinization Not effective for short acting Hemodialysis Activated charcoal? Poison control consult OverdoseTreatment

  7. Tolerance develops rapidly Withdrawal Minor symptoms by 24 hours Major – life threatening symptoms 2 – 8 days Worse with short acting Barbiturate Abstinence Syndrome

  8. Minor symptoms Anxiety, restlessness Depression, insomnia N/V, muscle twitching Cramping, sweating Major symptoms Psychosis, hallucinations Delirium, seizures Cardiovascular collapse Barbiturate Abstinence Syndrome

  9. Questions?

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