Pharm
Barbiturate
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Barbiturate
, Mephobarbital, Amobarbital, Pentobarbital, Secobarbital
See Also
Phenobarbital
Thiopental
Meprobamate
Indications
Status Epilepticus
(esp. infants,
Phenobarbital
,
Thiopental
)
Benzodiazepine Withdrawal
Rapid Sequence Intubation
(e.g.
Thiopental
)
Background
Barbiturates are
Sedative-Hypnotic
s that have been medically available since the early 1900s
Other
Sedative-Hypnotic
s (e.g.
Benzodiazepine
s) were developed as an alternative to the adverse effects of Barbiturates
Mechanism
GABA A Receptor Agonist
Other GABA A receptor agonists include
Alcohol
and
Benzodiazepine
s
Barbiturates have synergistic activity with
Benzodiazepine
s
BABA Receptor agonists result in prolonged duration of GABA channel opening
Allows for
Calcium
influx
Effects
Sensation
and motor function suppressed
Cerebellum
altered function
Sedation
Amnesia
Preparations
Long-Acting Barbiturates (duration 10-12 hours)
Phenobarbital
Mephobarbital
Short-Acting Barbiturates (duration 3-6 hours)
Amobarbital
Historically was used during psychoanalysis, and for determining dominant hemisphere before neurosurgery
Pentobarbital
Secobarbital
Very-Short Acting Barbiturates (duration <3 hours)
Methohexital
Thiopental
Has been used as induction agent in
Rapid Sequence Intubation
(rarely used)
Consider for
Increased Intracranial Pressure
(Fastest lowering of ICP of any induction agent)
Contraindicated in hypotensive patients or porphyria
Risk of skin necrosis if infiltrates (highly alkalotic agent with pH 10)
Propanediol
Carbamate
s (Barbiturate-Like agents)
Meprobamate
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