Barbiturates Narcotics

CNS depressants (e.g., barbiturates, narcotics, benzodiazepines, short-term use of large doses of alcohol)... 

CNS depressants When barbiturates, narcotics, other hypnotics (or systemic anesthetics), or other CNS depressants are to be given in conjunction with magnesium, adjust their dosage with caution because of additive CNS depressant effects of magnesium. 

Aspirin + Butalbital, Caffeine, Codeine (Fiorinal + Codeine) [C-lll] [Analgesic Barbiturate Narcotic] Uses ... 

Fatalities due to acute BZD overdose alone are extremely rare. Nevertheless, fatal overdoses with triazolam in the elderly have been reported ( 192, 193). Even with ingestion of massive doses, recovery appears to be rapid and without serious complications or aftereffects ( 194, 195, 196 and 197). Combined ingestion of BZDs with other CNS depressants (alcohol, barbiturates, narcotics, orTCAs), however, may result in severe CNS and respiratory depression or hypotension. Severity of symptoms appears to depend more on the type and quantity of the other drugs than on the BZD plasma level (194, 195, 196 and 197). 

The following method was outlined from the paper of Heaton and Blumberg57. They used the popular solvent system, CHCl3-acetone (9 1). (See Table III for 7 references using this system.) They have successfully employed the method for detection of barbiturates, narcotics, and amphetamines in urine of patients receiving psychotropic drugs. The procedure can be used for pharmaceutical dosage forms. 

Ethchlorvynol or phenobarbital may be used in the management of withdrawal symptoms. The CNS depressant effects of ethchlorvynol will be enhanced by alcohol, barbiturates, narcotics, and numerous other drugs. Ethchlorvynol will reduce the hypoprothrombinemic effects of anticoagulants requiring dose adjustment of the anticoagulant. 

Additive effects are likely after concomitant use of nortriptyline with CNS depressants, including alcohol, analgesics, barbiturates, narcotics, tranquilizers, and anesthetics (oversedation) atropine and other anticholinergic drugs, including phenothiazines, antihistamines, meperidine, and antiparkinsonian agents (oversedation, paralytic ileus, visual changes, and severe constipation) and metrizamide (increased risk of convulsions). 

These drugs decrease pain, increase range of motion and have a sedative effect on the patient. Centrally acting muscle relaxants should not be taken concurrently with central nervous system depressants such as barbiturates, narcotics, and alcohol. 

Heaton, A.M., and Blumberg, A.G. (1969) Thin-layer chromatographic detection of barbiturates, narcotics, and amphetamines in urine of patients receiving psychotropic drugs. Journal of Chromatography, 41,367-370. Ono, M., and Engelke, B.F. (1969) Procedures for assured identification of morphine, dihydromorphinone, codeine, norcodeine, methadone, quinine, methamphetamine, etc., in human urine. Bulletin in Narcotics, 21, 31-40. 

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