Barbiturates: Therapeutic use

Last modified: Thursday, 25. December 2008 - 6:08 am

 

Barbiturates produce forms of central nervous system depression. Reactions to these drugs range from mild sedation (producing sleep) to a coma. Doctors may prescribe barbiturates as sedatives to calm patients’ nerves, reduce tension or help them sleep. The drugs are also used as an anticonvulsant to control epileptic seizures.

In addition, the sleep-producing action of barbiturates is used to relax and partially anesthetize patients before some surgical procedures. Before some major brain surgeries, barbiturates (usually pentobarbital or thiopental) are used to temporarily induce coma in an effort to protect the brain; these drugs can reduce the metabolic rate of brain tissue and control cerebral blood flow.

Ultrashort-acting barbiturates

The ultrashort-acting barbiturates methohexital (Bre-vital), thiamylal (Surital), and thiopental (Pentothal) are administered as an anesthetic before surgery. The barbiturate is injected into the patient’s vein to induce anesthesia. The patient then receives a longer-acting anesthetic like nitrous oxide. The drugs are used in hospital settings and are not subject to abuse, according to the DEA.

Short-acting and intermediate-acting barbiturates

The barbiturates in these categories are pentobarbital (Nembutal), secobarbital (Seconal, Amatyl), a combination of amobarbital and secobarbital (Tuinal), bubalbital (Florinal, Fioricet), butabarbital (Butisol), talbutal (Lotusate), and aprobarbital (Alurate).

Short-acting and intermediate barbiturates are prescribed as sedatives and sleeping pills. In addition, veterinarians use pentobarbital to anesthetize animals. This barbiturate is also used to euthanize or put animals to sleep.

Long-acting barbiturates

The long-acting barbiturates phenobarbital (Luminal) and mephobarbital (Mebaral) are used medically to help a patient sleep. Another use is day-long sedation, a procedure that treats tension and anxiety. Furthermore, long-acting barbiturates are used with other drugs in the treatment of convulsive conditions like epilepsy.

Phenobarbital is the oldest antiepileptic drug in common use and has a solid efficiency record for the control of seizure. However, due to some side effects (hypertension, depression, dizziness, rash, memory lapses) and drug interactions (primarily other anticonvulsants), phenobarbital is now generally used as a second-line treatment.

Assisted suicide

After Oregon voters in 1997 approved the Death with Dignity Act, terminally ill people could receive prescriptions for lethal dosages of drugs so that they could end their lives. To be eligible for the Death with Dignity drugs, the person needed a diagnosis of less than six months to live. That diagnosis would be verified by two physicians, who would also determine that the person was competent when the decision was made.

Secobarbital was prescribed to 67 out of 70 patients during 1998 through 2000, according to an Oregon Public Health Services report.

 

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