Barbiturates are drugs that are derivatives of barbituric acid, which have a depressant effect on the central nervous system. They have a strong effect, and therefore it is important to take them in doses 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.
Drug list
Before talking about barbiturate poisoning, it is necessary to list some of the popular medicines that belong to this group. Since it is precisely because of their excessive intake that overdoses occur. The list is:
- Luminal.
- Amutal.
- Librium.
- Butizol.
- Alyurat.
- Seconal.
- Reposal.
- "Flurazepam hydrochloride".
- Terazine.
- Barbamil.
- Valium.
- Phenobarbital.
- Lotuzat.
- Estimal.
- Chloral Hydrate.
- "Nizatrepam".
- Triazolam.
- Talbutal.
- "Flunitrazepam".
- "Brevital".
Of course, this is only a small list of drugs belonging to this group. It should be noted that drugs differ in the duration of exposure. Some act literally 5-15 minutes (they are used to calm a person before introducing anesthesia), others - about 6 hours.
How does an overdose happen?
Typically, the cause of barbiturate poisoning is one of two things - either a suicide attempt or an accidental overdose.
After the agent 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, coma may develop. Pain, tactile and tendon reflexes also disappear.
Toxic effects cause a decrease in the tone of blood vessels, as well as a deterioration in contractility.
Hemodynamic disorders
Barbiturate poisoning leads to them first of all. Here is what happens as a result:
- Decrease in cardiac output.
- Reduce blood and venous pressure.
- Decreased blood volume.
- Tissue hypoxia.
Also, paralysis of the respiratory and vasomotor center begins to develop. If timely help is not provided to a person, a fatal outcome is possible against the background of cardiac and respiratoryfailure.
Due to violations of hemodynamics, there is also a failure in metabolism. Heat dissipation increases, body temperature decreases. Although, if acute barbiturate poisoning occurs in a child, he, on the contrary, will develop 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 contained in the blood also increases.
Sleep stage
It is necessary to make a reservation that the clinical picture of poisoning includes several stages. The first is the sleep stage. Signs of barbiturate poisoning are as follows:
- Ataxia.
- Apathy.
- Muscle weakness.
- Drowsy.
- Unclear speech.
- Increased salivation.
- Pupillary constriction (response to light persists).
Reflex activity is present at this stage, and there are also no cardiovascular and respiratory disorders.
What to do?
Noticing the above signs of barbiturate poisoning, emergency care should be provided immediately. Because in one of the next stages, which will be discussed later, a person may faint. And help should be provided when the person is still conscious.
You need to call an ambulance first. Then - rinse the stomach. The victim should drink about a liter of warm water in one gulp. Then he is pressed on the root of the tongue, thereby causing vomiting. All the liquid drunk should leave the stomach along with the medicine that has not had time to be fully absorbed.
Then the person should consume an aqueous suspension of activated charcoal. Suitable "Filtrum STI" or "Smekta", 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 has lost consciousness at the stage of falling asleep, it is strictly forbidden to wash the stomach. Having called an ambulance, he must be laid on his side in bed, also covered with a blanket. This will prevent mechanical asphyxia, which can cause aspiration of vomit or retraction of the tongue.
Stage of superficial coma
Unfortunately, if it comes, then it is useless to provide emergency care for barbiturate poisoning. It remains to wait for the doctors. The patient loses consciousness, he falls into a deep sleep, pupils constrict. Corneal, tendon and pupillary reflexes are also weakened.
Needle stiffness is common at this stage. Pathological reflexes of Babinsky and Rossolimo may appear. The frequency of respiratory movements decreases, the skin and mucous membranes become bluish.
The pulse becomes frequent, blood pressure may also change, but not much - it remains within the normal range.
Deep coma stage
It develops if the symptoms of poisoningbarbiturates were ignored, and the man was not given first aid. In this case, the following consequences occur:
- Areflexion.
- Bradycardia.
- Severe cyanosis of the skin and mucous membranes.
- Lack of muscle tone.
- Sharp drop in temperature.
- Cooling limbs.
- Sharp constriction of the pupils, followed by dilation during hypoxia.
- Hypotension.
- Weak, slow, shallow breathing.
Post-comatose period
The stage described above can last from a couple of hours to several days. When providing medical care, a person comes out of a coma. But for a certain 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.
- Eye Convergence.
- Nystagmus.
- Motor anxiety.
- Transient neurological impairment.
- Psychic stunned.
If help was not provided in time, then after the post-coma period, complications may begin to develop. Mental disorders, bronchopneumonia, bedsores, pulmonary and cerebral edema, mechanical asphyxia are often formed.
Therapy
Unfortunately, no specific antidote has been developed. Barbiturate poisoning has many consequences, and therefore treatment is carried outcomplex.
Mandatory stage - infusion therapy and elimination of toxins through the genitourinary system. To do this, use insulin, sodium bicarbonate, ascorbic acid and glucose.
You also need to reduce hypoxia. For this, drugs such as Mexidol, Piracetam and Vinpocetine are used.
If a person has respiratory failure, caffeine is administered to him. An antidote in this case can also be an antagonist of sleeping pills.
Which drug will be chosen depends on the drug that poisoned the person. So, for example, with an overdose of Diazepam, Naloxone is administered. If the victim was poisoned by Cyclobarbital or Phenobarbital, he is shown Bemegrid.
When swelling of the brain tissue occurs, the patient is given a plasma transfusion, and then prescribed diuretics. This is necessary for the excretion of toxic agents by the kidneys. Still have to take 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. Daily walks in the fresh air will be useful.
It is also recommended to pay special attention to your kidneys and liver. It will be useful to use mineral water, herbal decoctions, infusions and teas.
Effective and rose hips - you need to pour 2-3 tbsp. l. dried berries with boiling water (300 ml), boil, sweat, and thencool down. After filtering, you can drink, it is allowed to add a little sugar. Drinking this tea daily will help cleanse the kidneys.
Reviews
People who have used prescribed barbiturate drugs often leave negative comments about these drugs.
Take Phenobarbital, for example. People who have taken it for epilepsy say that side effects occur even when the drug is used 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.
People are also not always enthusiastic about other drugs with barbiturates. Many note a short-term improvement in the condition in the first days of admission, but then the effect disappears. Excitability increases, sleep problems appear, convulsions "deepen". In general, not everyone recommends solving their he alth problems with the help of such medicines.
Important to know
Much has been said above about barbiturate poisoning. Treatment of a post-coma state will take a lot of effort, time and he alth, and therefore, when taking these drugs, we must remember: exceeding the dose can lead not to calmness and quick falling asleep, but to eternal sleep.
In fact, barbiturates are rarely used today. Because the use of drugs in this group is capable oflead to microsomal induction in the liver. The active ingredients of the medicines penetrate the blood intensively, which is why the uncontrolled effect occurs quickly.
Of course, the use of barbiturates is contraindicated for the elderly, pregnant women, children, as well as people with serious problems with the gastrointestinal tract, cardiovascular system, kidneys, liver, etc. Because the side effect is inhibition of myocardial contraction. For some people, this action can be fatal, and no remedy for barbiturate poisoning will help.
It is also impossible not to mention that these funds 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 means quickly die. They do not even have time to develop cirrhosis of the liver - the most immediate consequence of the abuse of these medications. This is why barbiturates are banned in many countries.
