Barbiturates are drugs that are derivatives of barbituric acid, which have a depressing effect on the central nervous system. They have a strong effect, and therefore it is important to take them dosed and as directed by a doctor.
Barbiturate poisoning can lead to negative consequences. And now we will talk about what symptoms indicate an overdose, what to do in such cases, and what is the further treatment.
List of drugs
Before you talk about poisoning with barbiturates, you need to list some popular medicines that belong to this group. Since it is precisely because of their excessive intake that overdoses occur. The list is as follows:
- "Luminal".
- Amutal.
- Librium.
- Butisol.
- "Alurat."
- "Seconal."
- "Reposal."
- "Flurazepam hydrochloride."
- "Terazin".
- "Barbamil."
- "Valium."
- "Phenobarbital."
- "The lotus."
- Estimal.
- Chloral Hydrate.
- "Nizatrepam."
- Triazolam.
- Talbutal.
- "Flunitrazepam."
- Brevital.
Of course, this is only a small list of drugs that belong to this group. It should be noted that medicines differ in the duration of exposure. Some act literally 5-15 minutes (they are used to calm before a person is anesthetized), others - about 6 hours.
How does an overdose occur?
Typically, the cause of barbiturate poisoning is one of two things - either an attempted suicide or an accidental excess of the therapeutic dose.
After the drug enters the body in a toxic dose, the function of the cerebral cortex, as well as the brain stem, is inhibited. A person loses consciousness, breathing is disturbed, a coma may develop. Pain, tactile and tendon reflexes also disappear.
Toxic effects cause a decrease in blood vessel tone, as well as a deterioration in contractility.
Hemodynamic disorders
The poisoning with barbiturates leads to them first of all. Here is what happens as a result:
- Decreased cardiac output.
- Decrease in arterial and venous pressure.
- Decreased circulating blood volume.
- Hypoxia of tissues.
Also, paralysis of the respiratory and vasomotor center begins to develop . If you do not help the person in time, a fatal outcome is possible against a background of heart and respiratory failure.
Due to hemodynamic disturbances, a metabolic failure also occurs. Heat transfer increases, body temperature decreases. Although, if an acute poisoning with barbiturates occurred in a child, he, on the contrary, will begin a fever. The reason is pronounced hypoxia of the subcortical centers of the brain.
In addition to the above, an overdose of barbiturates leads to disorders in the hypothalamic-pituitary system. As a result, diuresis is significantly reduced, anuria develops, and the amount of nitrogen in the blood also increases.
Stage of falling asleep
It must be noted that the clinical picture of poisoning involves several stages. The first is the stage of falling asleep. The signs of barbiturate poisoning are as follows:
- Ataxia.
- Apathy.
- Muscle weakness.
- Drowsiness.
- Blurred speech.
- Increased salivation.
- Narrowing of the pupils (reaction to light persists).
Reflex activity is present at this stage, and cardiovascular and respiratory disorders do not occur.
What to do?
Having noticed the above signs of barbiturate poisoning, emergency care should be provided immediately. Because in one of the following stages, which will be described later, a person may faint. And help should be given when the person is still conscious.
First you need to call an ambulance. Then - rinse the stomach. The victim should gulp about a liter of warm water. Then he is pressed on the root of the tongue, thereby causing vomiting. All drunk fluid should leave the stomach with a medicine that has not had time to fully absorb.
Then a person should use an aqueous suspension of activated carbon. Suitable "Filtrum STI" or "Smecta", as well as any other sorbent.
After that, you need to put the person to bed, be sure to cover with a blanket and give sweet warm tea.
In the event that the victim lost consciousness at the stage of falling asleep, it is strictly forbidden to rinse the stomach. Having called an ambulance, he should be put to one side in bed, and also covered with a blanket. This will prevent mechanical asphyxiation, which can cause aspiration of the vomit or retention of the tongue.
Superficial coma stage
Unfortunately, if it comes, then providing emergency care for barbiturate poisoning is useless. It remains to wait for the doctors. The patient loses consciousness, he has a deep sleep, the pupils are narrowed. Corneal, tendon and pupillary reflexes are also weakened.
At this stage, stiff neck is often observed. Pathological reflexes of Babinsky and Rossolimo may appear. The frequency of respiratory movements decreases, the skin and mucous membranes acquire a bluish tint.
The pulse becomes frequent, blood pressure can also change, but not much - it remains within the normal range.
Deep coma stage
It develops if the symptoms of barbiturate poisoning were ignored and the person was not given first aid. In this case, the following consequences arise:
- Areflexia.
- Bradycardia
- Severe cyanosis of the skin and mucous membranes.
- Lack of muscle tone.
- A sharp drop in temperature.
- Limb cooling.
- A sharp narrowing of the pupils, alternating with hypoxia expansion.
- Hypotension.
- Weak, slow, shallow breathing.
Postcomatose period
The stage described above can last from a couple of hours to several days. When providing medical care, a person leaves a coma. But over a period of time (how long it takes - depends on the degree of intoxication) a number of severe symptoms persist. Among them:
- Impaired coordination of movements.
- Ptosis of the eyelids.
- Diplopia.
- Emotional lability.
- Convergence of the eyes.
- Nystagmus.
- Motor anxiety.
- Transient neurological disorders.
- Mental stun.
If help was not provided on time, then after a post-coma period complications may begin to develop. Often, mental disorders, bronchopneumonia, bedsores, pulmonary and cerebral edema, and mechanical asphyxia are formed.
Therapy
Unfortunately, no specific antidote has been developed. Barbiturate poisoning has many consequences, and therefore treatment is carried out comprehensively.
The mandatory stage is infusion therapy and the removal of toxins through the genitourinary system. For this, insulin, sodium bicarbonate, ascorbic acid and glucose are used.
You also need to reduce hypoxia. For this, drugs such as Mexidol, Piracetam and Vinpocetine are used.
If a person has respiratory failure, he is given caffeine. An antidote in this case can also be an antagonist of sleeping pills.
Which drug will be chosen depends on the medication with which the person was poisoned. So, for example, with an overdose of Diazepam, Naloxone is administered. If the victim has been poisoned by Cyclobarbital or Phenobarbital, he is shown Bemegrid.
When a swelling of the brain tissue occurs, the patient is given a plasma transfusion, and then a diuretic is prescribed. This is necessary for the elimination of toxic agents by the kidneys. Still have to use vitamins to improve metabolism and minimize hypoxia.
Recovery period
For some time after the elimination of the primary consequences, the person will continue to feel weak. It is recommended to lead a sparing lifestyle, not to expose yourself to physical and emotional stress. Useful daily walks in the fresh air.
It is also recommended that you pay special attention to your kidneys and liver. It will be useful to use mineral water, herbal decoctions, infusions and teas.
Rosehip is also effective - you need to pour 2-3 tbsp. l dried berries with boiling water (300 ml), boil, darken, and then cool. After filtering, you can drink, it is allowed to add a little sugar. Daily use of such tea will help cleanse the kidneys.
Reviews
People who used drugs with barbiturates as prescribed by doctors often leave negative comments about these drugs.
Take, for example, Phenobarbital. People who took it for epilepsy say that side effects occur even when taking the drug at the prescribed dose. Weakness, dizziness, apathy, low blood pressure - this is only a small part of the consequences. Even when patients stop taking the pills, mental retardation remains for several weeks.
From other drugs with barbiturates, people are also not always enthusiastic. Many note a short-term improvement in the first days of admission, but then the effect disappears. Excitability increases, problems with sleep appear, convulsions “deepen”. In general, not everyone recommends solving their health problems with the help of such medications.
It's important to know
Much has been said above about barbiturate poisoning. Treatment of a post-coma state will take a lot of energy, time and health, and therefore, when taking these drugs, we must remember: exceeding the dose can lead not to calm and fast falling asleep, but to eternal sleep.
In fact, barbiturates are very rarely used today. Because the use of drugs of this group can lead to microsomal induction in the liver. The active substances of medicines intensely penetrate the blood, which is why an uncontrolled effect occurs quickly.
Of course, the use of barbiturates is contraindicated in older people, pregnant women, children, as well as people who have serious problems with the gastrointestinal tract, cardiovascular system, kidneys, liver, etc. Because a side effect is the inhibition of myocardial contraction. For some people, this action can be fatal, and no remedy for poisoning with barbiturates will help.
Also, it is impossible not to mention that these drugs are strong toxic drugs. They are taken by opium addicts. Exceeding the dose causes a state of euphoria, reminiscent of alcohol intoxication. People "sitting" on such funds quickly die. They do not even have time to form cirrhosis of the liver - the quickest consequence of the abuse of these medicines. Therefore, in many countries barbiturates are prohibited.