Barbiturates

Question 1

Barbiturates

Answer 1

CNS Depressant. facilitate the actions of GABA by increasing the duration of the GABA-gated channel openings. Former Drug of Choice for Sedative-hypnotic effects. s.

Question 2

Barbiturates name ending

Answer 2

“bital”

Question 3

Barbiturate usage in PEDS

Answer 3

Since Barbs are older they all have established dosage guidelines for PEDS. Use Caution: Kids often have unpredictable results. Monitor kids for CNS Depression and Excitability, Aggressiveness

Question 4

Barbs Tx indications (general)

Answer 4

relieve anxiety, Sedation, insomnia, preanesthesia, Tx seizure, acute Manic episodes.

Question 5

General Barb Pharmacokinetics

Answer 5

Well absorbed. Lipid soluble. 20-60 min. In=Liver/Out=Urine. *Longer acting Barbs tend to excrete some unchanged in urine. Cross to placenta and BM.

Question 6

Barbiturate for Tx of Manic Reaction

Answer 6

Amobarbital. Decrease dose for elderly

Question 7

Barbiturate for SHORT TERM Sedative-Hypnotic effect

Answer 7

Butabarbital-reduce elderly dose, caution in kids for aggressive and excitability.

Question 8

Barbiturate Antiepileptic

Answer 8

Mephorbarbital-reduce elderly dose, caution in kids for aggressive and excitability, taper.

Question 9

Barbiturate Preanesthetic

Answer 9

Pentobarbital, Phenobarbital, and Secobarbital

Question 10

Phenobarbital Prototype Indications

Answer 10

Sedation, short-term Tx of Insomnia, Long-term Tx of tonic-clonic seizure, coritical focal seizure, emergency control of acute convulsive episode, preanesthetic

Question 11

Phenobarbital Prototype Actions

Answer 11

Inhibits RAS, Depress cerebral cortex, alters cerebellar Fx, Depresses motor outpout, can excite, sedate, hypnosis, anesthesia, deep coma, and anticonvulsant activity

Question 12

Phenobarbital Prototype Pharmacokinetics

Answer 12

Routes: Oral O=15min D=30-60 min, IM, SubQ, IV.

In Liver out urine

Question 13

Phenobarbital Prototype Adverse Effects

Answer 13

Somnolence, Agitation, Confusion, hyperkinesia, Ataxia, Vertigo, CNS depression, Hallucination, Brady, HypoTN, Syncope, Hypovent., Apnea, Withrawal, Rash, Stevens-Johnson syndrome and GI=N,V,C,D.

Question 14

Barbiturate DD Interaction MANY!

Answer 14

Alcohol, Antihistamine, tranquilizers, other CNS Depressants. Altered response to Phenytoin. MAO inhibitors=effects of oral anticoagulants, digoxin, tricyclic antidepressants, corticosteroids, oral contraceptive, estrogen, acetaminophen, metronidazole, carbamazepine, beta blockers, griseofulvin, phenylbutazones, theophyllines, quinidine, and doxycycline

Question 15

Barbiturate Contraindications

Answer 15

Allergy
Hx of addiction to sedative–hypnotic drugs
Latent or manifest porphyria
Marked hepatic impairment or nephritis
Respiratory distress or severe respiratory dysfunction
Pregnancy
Caution: Chronic Pain

Question 16

Stevens-Johnson syndrome

Answer 16

Severe sloughing of skin anywhere