Use of Barbiturates

Many teens do not know what barbiturates are and what harmful effects may arise from abusing them. It is important to understand why barbiturates and other drugs are abused and to learn about the ultimate consequences of abuse. 

Many parents and schoolteachers think their children and students can t get barbiturates or other drugs, but that is a misleading 

It is also easy for someone to find a local seller of illegal drugs, such as marijuana, who can probably get other drugs, 

Joey s parents were in the middle of a bitter and hateful divorce. Whenever they were in the house they yelled and screamed at each other. Forget about what happened when the two of them were in the same room. Joey did as much as he could to not be home. Thankfully he was 16 and could drive. He was able to go to friends houses, sleep over many nights, and basically go anywhere to be away from the mess at home. After some time, Joey started to need other ways to get away from his parents and from reality. 

Most barbiturates are not available in intravenous (IV) form, but if the abuser is able to inject the drug, the consequences of IV drug use may result. Abusers may catch an infection where they inject themselves, an infection of their blood (such as HIV) because of a dirty needle or one contaminated through sharing with other users, an air bubble that moves to their brain (an embolism, which usually results in death), pneumonia, or infection of the valves of the heart. 

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Although the use of barbiturates and miscellaneous sedatives and hypnotics for sedation has largely been replaced by the antianxiety drugs (see Chap. 30), they occasionally may be used to provide sedation before certain types of procedures such as cardiac catheterization or the administration of a local or general anesthesia Sedative doses usually given during daytime hours, may be used to treat anxiety and apprehension. Fhtients with chronic disease may require sedation, not only to reduce anxiety, but also as an adjunct in the treatment of their disease... 

Other methods for the determination of chlorine in seawater or saline waters are based on the use of barbituric acid [13] and on the use of residual chlorine electrodes [ 14] or amperometric membrane probes [15,16]. In the barbituric acid method [12], chlorine reacts rapidly in the presence of bromide and has completely disappeared after 1 minute. This result, which was verified in the range pH 7.5-9.4, proves the absence of free chlorine in seawater. A study of the colorimetric deterioration of free halogens by the diethylparaphenylene-diamine technique shows that the titration curve of the compound obtained is more like the bromine curve than that of chlorine. The author suggests... 

Sedation is an intermediate degree of CNS depression, while hypnosis is a degree of CNS depression similar to natural sleep. From the chemical point of view, soporific, sedative, and hypnotic drugs are classified as barbiturates, benzodiazepine hypnotics, and so on. Except for a few rare exceptions, any one of these compounds can be used for acquiring a sedative effect or state of sleep. Presently, the less toxic benzodiazepines are edging out the class of barbiturates more and more because of the possibility of chronic dependence associated with the use of barbiturates. Drugs of both classes are primarily CNS depressants, and a few of their effects, if not all, are evidently linked to action on the GABA-receptor complex. 

Most of the adverse reactions associated with the use of the intravenous barbiturates are predictable and therefore can be controlled or avoided. Some reactions, such as hypersensitivity, are entirely unpredictable. Particularly patients with asthma, urticaria, or an-gioedema may acquire allergic hypersensitivity to the barbiturates. Acute intermittent porphyria is an absolute contraindication to the use of barbiturates. 

The CNS depressants include barbiturates, nonbarbiturate sedatives, and the benzodiazepines. As the medical use of barbiturates decreased, primarily because of their high addiction liability and the danger of acute lethality, the use of the benzodiazepine anxiolytics increased. The most commonly abused barbiturates are secobarbital, pentobarbital, and amobarbital. Pheno-barbital is not generally abused, because of its slow onset of action. The most commonly abused anxiolytics include diazepam, chlordiazepoxide, midazolam, lo-razepam, and flurazepam. These drugs are readily attainable from illicit sources. 

Warnings about the dangers of nonprescription use of barbiturates did not have the intended effect. Instead of taking precautions about barbiturates, people wanted to try the drug that some called a thrill pill. ... 

The BZDs are also safer than the barbiturates because there is a large difference between the amount needed for sedation and the amount that would cause an overdose. Studies have shown that the rate of drug overdose decreased after the use of barbiturates began to decline and the BZDs were substituted. -... 

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... 

CURRENT MEDICAL USES OF BARBITURATES Sedative/Hypnotics... 

Illegal use of barbiturates can lead to many serious consequences, and these drugs should never be considered safe, unless prescribed and monitored closely by a physician. Tolerance can easily develop, and a small increase in dose can lead to intoxication or overdose. The withdrawal effects of barbiturate abuse, like other drugs, are very unpleasant and can cause abusers to continue abusing for fear of feeling worse than ever before if they were to stop. With the help of treatment centers and doctors, however, abusers can overcome the symptoms of withdrawal and stay on the road to addiction recovery. 

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... 

Decreased levels of antifungal drug with concomitant use of barbiturates, carbamazepine, rifampin, rifabutin... 

In adults, excessive alcohol consumption reduces liver reserves of vitamin A, both as a result of alcoholic liver damage and also by induction of cytochrome P450 enzymes that catalyze the oxidation of retinol to retinoic acid (as also occurs with chronic use of barbiturates). However, chronic consumption of alcohol can also potentiate the toxicity of retinol (Section 2.5.1). 

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