Barbiturates

They are used as sedatives, hypnotics, intravenous anaesthetics and in treatment of various diseases.
They are classified as:
1. Long acting: action lasts for 8 to 16 hours. eg. sodium barbitone, phenobarbitone and mephobarbitone

2. Intermediate acting: action lasts for 8 to 10 hours. eg. butobarbitone, amylobarbitone

3. Short acting: action lasts for 3 to 6 hours. eg. cylcobarbitone, hexabarbitone, secobarbital, pentobarbital

4. Ultra short acting: thiopentone and hexobarbitone

Route :
Ingestion
Fatal Dose :
5gm
Fatal Period :
1 to 2 days
Clinical Picture :
The stages of barbiturate poisoning are as follows:
1. awake, competent
2. sedated, reflexes present
3. comatose and reflexes present
4. comatose and areflexia
5. comatose with respiratory and circulatory disturbances

• Barbiturate automatism: with therapeutic dose there is induction of sleep and sometimes there results mental confusion so that person takes more drug
• In acute poisonin: giddiness, ataxia, slurred speech, stupor, flaccid limbs, areflexia, diplopia, absent bowel sounds and pupils that show alternate contraction and dilation. face becomes cyanosed, hypotension, hypothermia, bullae or blisters on skin{ barbiturate bullae}

Treatment :
• Gastric lavage
• enema and purgatives
• Maintain respiration
• Bemigrid, 50mg and Daptazol 15mg in i.v. drip
• Coramine, 5 to 10 ml i.v.
• Maintenance of BP
• Prophylactic antibiotics
• Diuresis, peritoneal or hemodialysis
• Symptomatic treatment

Barbiturates

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