Barbiturates overdosage

Toxic symptoms may be dose-dependent and merely an exaggeration of the therapeutically desirable response, e.g., the coma of barbiturate overdosage and persistence of muscular paralysis after succinylcholine administration, or an unpredictable effect of the drug upon an organ or tissue remote from that upon which the therapeutic effect is manifested. 

Severe anaphylactic reactions following intravenous administration of diazepam have been reported. Meprobamate causes toxicity similar to that of a barbiturate overdosage. Death may result from respiratory failure or hypotension. Limited information is available about the acute toxicity of Buspirone. Effects are merely extensions of pharmacological effects. Nausea, vomiting, dizziness, drowsiness, miosis, and gastric distention may be seen. 

McCarron MM, Schulze BW, and Walberg CB (1982) Short acting barbiturate overdosage. Correlation of intoxication score with serum barbiturate concentration. Journal of the American Medical Association 248 55-61. 

In many types of drug reactions, bullae and vesicles may be found in addition to other manifestations. Bullae are usually noted in erythema multiforme, Stevens-Johnson syndrome, toxic epidermal necrolysis, fixed eruptions when very intense, urticaria, vasculitis, porphyria cutanea tarda, and phototoxic reactions (from furosemide and nalidixic acid). Tense, thick-walled bullae can be seen in bromoderma and iododerma as well as in barbiturate overdosage. 

Barbiturates may increase the half-lives of drugs metabolized by the hver An increase in urinary pH will accelerate the elimination of phenobarbital Respiratory depression caused by barbiturate overdosage can be reversed by flumazenil Concerning the clinical uses of benzodiazepines and related drugs, which one of the following statements is accurate ... 

No health hazards are known with the proper use of kava (Gruenwald et al. 1998). Kava has been approved by the German Commission E for treatment of anxiety and insomnia. In clinical studies of kava for anxiety, adverse effects were uncommon and did not differ across placebo and kava groups. There do not appear to be any studies published on the effects of acute overdosage with kava. Given its CNS depressant effects, it should not be taken with other similar drugs, including benzodiazepines, barbiturates. 

With any hypnotic, the risk of suicidal overdosage cannot be ignored. Since benzodiazepine intoxication may become life-threatening only when other central nervous depressants (ethanol) are taken simultaneously and can, moreover, be treated with specific benzodiazepine antagonists, the benzodiazepines should be given preference as sleep remedies over the all but obsolete barbiturates. 

Overdosage with ethanol and sedative-hypnotic drugs (eg, benzodiazepines, barbiturates, 7-hydroxybutyrate [GHB], carisoprodol [Soma] see Chapters 22 and 23) occurs frequently because of their common availability and use. 

Respiratory depression Barbiturates suppress the hypoxic and chemoreceptor response to CO2, and overdosage is followed by respiratory depression and death. 

The toxic effects of an overdosage result from profound central depression and may include coma, respiratory and cardiovascular depression with hypertension, and shock leading to renal failure. Withdrawal of the drug is more frequently a problem with barbiturates than with benzodiazepines. Withdrawal of barbiturates leads to rapid eye movement (REM) sleep rebound and rebound insomnia. 

Overdosage with glutethimide (10 to 20 g) produces symptoms that are identical to those produced by barbiturates, which include profound CNS depression, hypothermia, altered deep-tendon reflexes, absence of corneal and papillary reflexes, absence of response to painful... 

Meclizine may potentiate the CNS depressant effects of alcohol, barbiturates, and anxiolytic agents. Its overdosage will cause drowsiness, restlessness, excitation, nervousness, insomnia, euphoria, blurred vision, diplopia, vertigo, tinnitus, and auditory and visual hallucinations. 

Overdosage Overdosage causes severe respiratory and cardiovascular depression these potentially lethal effects are more likely to occur with alcohols, barbiturates, and carbamates than with benzodiazepines. Management of intoxication requires maintenance of a patent airway and ventilatory support. Flumazenil may reverse CNS depressant effects of benzodiazepines, zolpidem, and zaleplon but has no beneficial actions in overdosage with other sedative-hypnotics. 

Overdosage, The untoward effects are directly related to the administered amount of drug (e.g., absolute overdosage, as in barbiturate suicide) or to its unexpected accumulation due to some excretory or metabolic abnormality in the patient (e.g., kidney or liver failure). 

In order to control drug overdosage, liver disease, and kidney disease, the adsorption of several bioactive drugs from aqueous solutions such as analgesics, steroids, aminoacids, hypnotics, ° and tranquilizers has been studied. The adsorption is completely reversible and follows Type I adsorption isotherm. Enzymes also adsorb reversibly, but they exhibit decreased activity in the adsorbed state. In some cases, physical adsorption is followed by chemisorption as in the case of aminopyrine, or by carbon catalyzed hydrolysis as in the case of diurectic benzothiodizines, or with nitrogen heterocyclic anti-inflammatory drugs. The adsorption of barbiturates on microporous carbons is considerably influenced by the... 

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