Alcohols and barbiturates

There are similarities between the biological actions of inhalants and those of alcohol and barbiturates (Bowen et al. 1996b). For example, acute administration of inhalants affects motor coordination (Moser and Balster 1981) and induces anxiolysis, whereas chronic administration is associated with physical dependence and withdrawal (Bowen et al. 1996a Evans and Balster 1991, 1993). In addition, some inhalant drugs have anticonvulsant properties (Wood et al. 1984). Like other CNS-depressant agents, inhalants have biphasic effects on spontaneous locomotor activity in rodents, with increased activity seen at lower doses and diminished locomotion seen at higher doses (Cause et al. 1985 Kjellstrand et al. 1985). 

Secobarbital exhibits the same pharmacologic properties as other members of the barbiturate class. Most nonmedical use is with short-acting barbiturates, such as secobarbital. Although there may be considerable tolerance to the sedative and intoxicating effects of the drug, the lethal dose is not much greater in addicted than in normal persons. Tolerance does not develop to the respiratory effect. The combination of alcohol and barbiturates may lead to fatalities because of their combined respiratory depressive effects. Similar outcomes may occur with the benzodiazepines. Severe withdrawal symptoms in epileptic patients may include grand mal seizures and delirium. 

Several pharmacological issues pertain to most CNS depressant drugs (Hobbs et al. 1996 Julien 1997). Depending on their pharmacological mechanisms, combinations of CNS depressants can produce additive or synergistic effects, when the total effect is equal to or greater than the sum of their individual effects, respectively. For example, in doses that would be safe individually, combinations of alcohol and barbiturates can be lethal. 

Drugs that may interact with pentazocine include alcohol and barbiturate anesthetics. 

D. These are classic features of opioid abstinence syndrome. The abstinence syndrome in chronic alcohol or barbiturate users consists of hallucinations, tremors, hyperthermia, and autonomic hyperactivity. The abstinence syndrome for users of cocaine and amphetamine is not as stereotyped as for opioids or CNS depressants, such as alcohol and barbiturates. 

Avoid alcohol and barbiturates while taking ondansetron... 

Avoid alcohol and barbiturates during palonosetron therapy... 

Because alcohol and barbiturates also act, in part, via the GABA receptor-mediated chloride ion channel, benzodiazepines show cross-tolerance with these substances. Thus, benzodiazepines are used frequently for treating alcohol or barbiturate withdrawal and detoxification. Alcohol and barbiturates are more dangerous than benzodiazepines because they can act directly at the chloride ion channel at higher doses. In contrast, benzodiazepines have no direct effect on the ion channel the effects of benzodiazepines are limited by the amount of endogenous GABA. 

Di Chiara, Gaetano, and Assunta Impcrato. 1986. "Preferential Stimulation of Dopamine Release in the Nucleus Accumbens by Opiates, Alcohol, and Barbiturates Studies with Transcerebral Dialysis in Freely Moving Rats." Annals of the New York Academy of Sciences 473 367-81. 

Many cases document the synergistic effect of alcohol and barbiturates as a cause of death in cases appearing to be suicide. Alcohol itself is probably the most frequent cause of death due to poisoning. 

Heroin withdrawal is much less dangerous than alcohol and barbiturate withdrawal. Withdrawal symptoms are craving for opioid, restlessness, irritability, increased sensitivity to pain, nausea, cramps, muscle and bone aches, insomnia, anxiety, cold flashes with goose bumps (cold turkey), and movements (kicking the habit).5... 

Barbiturate overdose may be treated with gastric lavage and oral administration of activated charcoal. Supportive therapy of cardiovascular, respiratory, and renal function also should be provided. Coadministration of alcohol and barbiturates may increase the sedative effect of chloral hydrate. Long-term use of barbiturates leads to dependence. Sudden discontinuation of an antipsychotic drug may cause withdrawal symptoms such as nausea, vomiting, anorexia, diarrhea, rhinorrhea, sweating, insomnia, restlessness, and vertigo.151... 

Although the opioid analgesics can produce mood elevation (euphoria) in some patients and sedation in others, the more common side effect is CNS depression manifested as drowsiness.A strategy to reduce sedation or drowsiness is to decrease the analgesic dose and shorten the interval between doses. Clinicians should note that the sedative effect of opioid analgesics is additive with the sedative effects of hypnotics such as alcohol and barbiturates. These depressive agents must be avoided when opioids are prescribed. 

In overdose, depression of respiratory and vasomotor centers in the medulla occurs with most drugs in this class, although the dose-response relationship is flatter for the benzodiazepines than for older drugs such as alcohol and barbiturates. 

Particular groups of drugs known to be potentially harmful to the foetus in the first trimester include male and female hormones, iron preparations, aspirin-like drugs, alcohol and barbiturates. 

Phenothiazine derivatives potentiate the CNS-depressing effects of alcohol and barbiturates and shorten the onset of action of anesthetics. 

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