Barbiturate Abuse

Aka: Barbiturate Abuse, Barbiturate withdrawal

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II. Class

  1. Sedative-Hypnotic

III. Preparations: Forms

  1. Phenobarbital
  2. Nembutal
  3. Seconal
  4. Amytal

IV. Preparations: Street Names

  1. Blue Devils
  2. Yellow Jackets
  3. Blue Heavens
  4. Downers
  5. Barbs

V. Pharmacokinetics

  1. Seconal (30-500 mg): 6-8 hours duration

VI. Signs: Withdrawal

  1. Seizure
  2. Delirium

VII. Management: Overdose

  1. Supportive care with airway management for CNS Depression (similar to Benzodiazepines)
  2. Urine Alkalinization with Sodium Bicarbonate

VIII. Management: Withdrawal Protocol (Barbiturate Taper)

  1. See also Barbiturate Equivalents
  2. Pentobarbital challenge (shorter half life)
    1. Start: 200 mg Pentobarbital
    2. Then: 100 q2 hours until mildly intoxicated
  3. Switch to Phenobarbital
    1. Convert: 30 mg Phenobarbital = 100 mg Pentobarbital
    2. Decrease Phenobarbital by 10% per day

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Related Topics in Chemical Dependency

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