Effects of barbiturates

The side effects of barbiturates include sedation, poor physical coordination, and impaired mental performance. They also potentiate the intoxicating effects of alcohol. Barbiturates can be extremely dangerous in overdose, causing anesthesia, coma, and even death. In addition, barbiturates can cause dangerous suppression of breathing in patients with sleep apnea or other respiratory disorders. With repeated use over just a few weeks, physical dependence and tolerance to their effects can develop, leading to increasing doses to maintain the desired therapeutic effect. If a... 

Mannitol (OsmitroL others) [Osmotic Diuretic] Uses Cerebral edema, T lOP/ICP, renal impair, poisonings Action Osmotic diuretic Dose Test dose 0.2 g/kg/dose IV over 3-5 min if no diuresis w/in 2 h, D/C Oliguria 50-100 g IV over 90 min T lOP 0.5-2 g/kg IV over 30 min Cerebral edema 0.25-1.5 g/kg/dose IV >30 min Caution [C, ] w/ CHF or volume overload Contra Anuria, dehydration, HE, PE Disp Inj SE May exacerbate CHF, N/V/D Interactions t Effects OF cardiac glycosides X effects OF barbiturates, imipramine, Li, salicylates EMS Monitor ECG for hypo-/hyperkalemia (T wave changes) OD May cause dehydration, t urine frequency/amount hypotension and CV collapse symptomatic and supportive... 

Pharmacodynamic tolerance, probably on the basis of down-regulation of receptors, develops more rapidly to the effects of barbiturates on mood and sedation than to the anticonvulsant and lethal action. This results in a marked decrease in therapeutic index and the ratio of LD50 and ED50 can approach 1. Furthermore, barbiturates induce P450 enzymes and thus increase their own metabolism resulting in time dependent pharmacokinetic behavior. 

GNS depressants are drugs that decrease brain activity, resulting in both behavioral and physiological changes. The effects of alcohol on coordination, speech, and cognitive functions are familiar to most people. The effects of barbiturates are similar to alcohol. In low doses, barbiturates act as sedatives increased doses have a hypnotic or sleep-inducing effect and stiU larger doses have anticonvulsant and anesthetic activity, and can lead to respiratory depression, coma, and death. Barbiturate addicts... 

The depressant effect of barbiturates is often sought by persons who are self-medicating for amdety-related problems or insomnia. Drugs of the benzodiazepine family (Librium, Valium, and Xanax) are also legitimately prescribed for the treatment of anxiety as well as muscle spasms or convulsions. However, doctors and patients must be careful because prolonged or excessive use can lead to dependence. Illegal use often involves forged prescriptions or the cooperation of illicit doctors. 

Tea Tree (Melaleuca alternifolia) Uses Rx of superficial wounds (bacterial, viral, fungal, insect bites, minor burns, cold sores, acne Action Broad-spectrum antibiotic activity against E. coli, S. aureus, C. albicans Available forms Topical creams, lotions, oint, oil apply topically PRN Notes/SE Ataxia, contact dermatitis, D, drowsiness, GI mucosal irritation Interactions Effects OF drugs that affect histamine release EMS effects of Benadryl Valerian (Valeriana officinalis) Uses Anxiolytic, antispasmodic, dys-menorrheal, restlessness, sedative Action Inhibits uptake stimulates release of GABA, which T GABA concentration extracellularly causes sedation Available forms Ext 400-900 mg PO 30 min < hs, tea 2-3 g (1 tsp of crude herb) qid, PRN, tine 3-5 mL (1/2-1 tsp) (1 5 ratio) PO qid, PRN Efficacy Probably effective sedative (reduces sleep latency) Notes/SE GI upset, HA, insomnia, N/V, palpitations, restlessness, vision changes Interactions T Effects OF barbiturates, benzodiazepines, opiates, EtOH, catnip, hops, kavakava, passion flower, skullcap effects OF MAOIs, phenytoin, warfarin EMS T Effects of benzodiazepines and opiates abruptly D/C may cause withdrawal symptoms... 

Naloxone (Narcan) and naltrexone hydrochloride (Trexan) reverse the respiratory depressant action of narcotics related to morphine, meperidine, and methadone. They differ from other narcotic analgesics in several respects. Naloxone does not cause respiratory depression, pupillary constriction, sedation, or analgesia. However, it does antagonize the actions of pentazocine. Naloxone neither antagonizes the respiratory depressant effects of barbiturates and other hypnotics nor aggravates their depressant effects on respiration. Similar to nalorphine, naloxone precipitates an abstinence syndrome when administered to patients addicted to opiate-like drugs. 

The mental effects of barbiturates depend on the amount of the drug taken and the strength of the dosage. Generally, a person falls asleep when taking a prescribed dosage at bedtime. 

Older adults and pregnant women should consider the risks associated with barbiturate use. When a person ages, the metabolization rate for drugs decreases. As a result, people over age 65 are at higher risk of the harmful effects of barbiturates. There is also greater risk for drug dependence. 

From the 1940s on, people took amphetamines, the highly addictive drugs referred to as uppers, during the day. They used amphetamines to increase their energy and to relieve the effects of barbiturates. Those effects could include sleepiness and hangover symptoms. 

In some ways, the effects of barbiturates are predictable. Prolonged barbiturate use can shorten a person s attention span. The person may suffer memory loss. Both conditions would make it difficult for a person to do well in school or perform on a job. 

Valerian (Valerian officinalis). No drug interactions have been reported, but animal studies suggest that valerian, used as a sedative and sleep aid, might increase the effects of barbiturates such as pentobarbital, hexo-barbital, and thiopental. 

Although benzodiazepines were originally believed to have fewer harmful side effects than barbiturates, scientists and others who study these drugs now say benzodiazepines actually share many of the same undesirable side effects of barbiturates and are every bit as dangerous in certain circumstances. 

Depending on dosage, barbiturates may act as either sedatives or as hypnotics. Subjectively, the effects of barbiturates are very similar to those of alcohol. Like alcohol intoxication, a barbiturate state of intoxication involves... 

Tolerance to many of the effects of barbiturates develops rapidly, but it is a characteristic of this class of drugs that tolerance to the effects does not develop uniformly. Tolerance builds to the euphoric effects but not to the lethal dose euphoric doses come closer and closer to the lethal dose. 

J. Yanai, An animal model for the effect of barbiturate on the development of the central nervous system, in J. Yanai (Ed.), Neurobehavioral Teratology, Elsevier, Amsterdam, 1984, pp. 111-132. 

Use of barbiturates combined with many other medications has been reported to alter the effects of barbiturates or the other drugs. Most of these drug interactions have been specifically reported with the barbiturate phenobarbital. There are... 

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