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Is your patient on barbiturates?

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This Post is adapted from the Canadian Pharmacists Association (CPhA) Drug Monograph: Barbiturates

Barbiturates

Product Summary Information

Product Information Table

 

  • Barbiturates are nonselective central nervous system (CNS) depressants, capable of producing all degrees of depression from mild sedation and hypnosis to general anesthesia, deep coma and death.
      • The extent of CNS depression varies with the route of administration, dose and pharmacokinetic characteristics of the particular barbiturate. Patient-specific factors such as age, physical or emotional state and the concomitant use of other drugs will also affect response.
Indications
  • Barbiturates have been used parenterally in the management of status epilepticus or acute seizure episodes that are secondary to meningitis or other causes.
  • Butalbital is used in combination with analgesics in the management of mild to moderate headache. 
  • Phenobarbital and primidone are used as second-line or adjunctive agents in the management of simple or complex partial seizures with or without secondary generalization.
  • Phenobarbital is sometimes used in the management of acute alcohol withdrawal; it has also been used in combination with ergotamine and belladonna in the treatment of migraine.
  • Pentobarbital is used as a sedative prior to surgery or other procedures.
  • Pentobarbital is used in certain cases of increased intracranial pressure.
Interactions
  • Corticosteroids: Barbiturates may increase the metabolism of corticosteroids. There have been several reports of exacerbation of asthma and other conditions when barbiturates were added to regimens containing corticosteroids.
  • Doxycycline: Barbiturates have been reported to increase the metabolism and correspondingly reduce the effectiveness of doxycycline.
 
Source:
Canadian Pharmacists Association: Compendium of Pharmaceuticals and Specialties, online version (e-CPS), accessed on April 26, 2013
 

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