Barbiturates
Included In This Lesson
Outline
Overview
I. Overview
A. Purpose
1. CNS depression
2. Sedative and hypnotic effects
3. Reducing the nerve impulses traveling to cerebral cortex
B. Mechanism of Action
1. Potentiate the action of an inhibitory amino acid known as gamma-aminobutyric acid (GABA)
II. Indications
A. Anesthesia (surgical procedures)
B. Convulsion control
C. Narcoanalysis
D. Reduction of ICP (neurosurgical patients)
E. Epileptic seizure prophylaxis
F. Neonatal hyperbilirubinemia
G. Sedative-hypnotic needs
III. Types
A. Secobarbital
B. Butobarbital
C. Methohexital
D. Mephobarbital
E. Thiamylal
F. Thiopental
G. Phenobarbital
H. Pentobarbital
IV. Contraindications
A. Drug allergy
B. Pregnancy
C. Respiratory disease
D. Liver disease
V. Interactions
A. Anticoagulants = possible clot formation
B. Inhibited drug breakdown
1. Monoamine oxidase inhibitors (MAOIs)
2. Anticoagulants
3. Glucocorticoids
4. Tricyclic antidepressants
5. Quinidine
6. Oral contraceptives *accelerated metabolism
C. Additive CNS depression
1. Alcohol
2. Antihistamines
3. Benzodiazepines
4. Opioids
5. Tranquilizers
VI. Side Effects
A. Respiratory
1. Respiratory depression
2. Apnea
3. Laryngospasms
4. Bronchospasms
5. Coughing
B. CNS
1. Drowsiness
2. Vertigo
3. Headache
4. Depression
C. Hematologic
1. Thrombocytopenia
2. Anemia
D. Gastrointestinal
1. N / V / D
2. Constipation
E. Cardiovascular
1. Vasodilation
2. Hypotension
F. Other
1. Urticaria
2. Angioedema
3. Fever
4. Stevens-Johnson syndrome
Transcript
Welcome back and today we are going to discuss barbiturates.
The purpose of barbiturates is 3-fold: CNS depression, sedative and hypnotic effects, and the reduction of impulses to the cerebral cortex.
The mechanism of actions with barbiturates is based on their inhibition of GABA.
The indications for barbiturates include convulsion control, anesthesia, narcoanalysis (truth serum therapy), neonatal hyperbilirubinemia, reduction of ICU, epileptic seizure prophylaxis and sedative-hypontic needs. An easy way to remember this is CANNRES.
The types are barbiturates are plentiful with varying names but most have the same ending -BARBITAL. Don’t try to remember the full name, focus on -BARBITAL.
Contraindications include drug allergy, pregnancy (birth defects), respiratory disease (decreased breathing patterns, apnea) and liver disease (can cause liver injury). A way to remember this section is DPRL.
Interactions for barbiturates include anticoagulants, which can cause possible clot formation.
One unique Interaction for barbiturates is its inhibition or acceleration of medications. MAOIs, anticoagulants, glucocorticoids, tricyclics, quinidine will interact with inhibition or delay medication responses. While oral contraceptives are an acceleration response. An easy way to remember these is MAGTQO.
Barbiturates have additive interaction as well. When taken with alcohol, antihistamines, benzodiazepines, opioids or tranquilizers. Meaning, their effects of magnified when used together. An easy way to remember these are AABOT.
Side effects for barbiturates include 4 profiles – the first being respiratory. It includes respiratory depression, apnea, bronchospasms, and coughing.
Side effects for the CNS profile include drowsiness, vertigo, headache, and depression.
Side effects for the hematologic profile include Thrombocytopenia and anemia.
Side effects for the GI profile include Nausea, vomiting, diarrhea, and constipation.
Side effects for the cardiovascular profile include Vasodilation and hypotension.
The last side effect profile is other and includes Urticaria, angioedema, fever and Stevens-Johnson syndrome (flu-like symptoms which leads to painful blisters).
Nursing concepts for a patient taking barbiturates include intracranial regulation and pharmacology.
Okay, let’s review. The indications for barbiturates include convulsion control, anesthesia, narcoanalysis (truth serum therapy), neonatal hyperbilirubinemia, reduction of ICU, epileptic seizure prophylaxis and sedative-hypnotic needs. An easy way to remember this is CANNRES. Most barbiturates have the same ending -BARBITAL. Contraindications include drug allergy, pregnancy (birth defects), respiratory disease (decreased breathing patterns, apnea) and liver disease (can cause liver injury). A way to remember this section is DPRL. One unique Interaction for barbiturates is its inhibition or acceleration of medications. MAOIs, anticoagulants, glucocorticoids, tricyclics, quinidine will interact with inhination or delay medication responses. While oral contraceptives are an acceleration response. An easy way to remember these is MAGTQO. Barbiturates have additive interactions as well. When taken with alcohol, antihistamines, benzodiazepines, opioids or tranquilizers. Meaning, their effects of magnified when used together. An easy way to remember these is AABOT. Lastly, the side effects covered 6 profiles – respiratory, CNS, heme, GI, cards and others.
You know now the important details regarding barbiturates. Now, go out and be your best self today and as always, Happy Nursing!
Tiona RN
Concepts Covered:
- Studying
- Medication Administration
- Adult
- Emergency Care of the Cardiac Patient
- Intraoperative Nursing
- Microbiology
- Cardiac Disorders
- Vascular Disorders
- Nervous System
- Upper GI Disorders
- Central Nervous System Disorders – Brain
- Immunological Disorders
- Fundamentals of Emergency Nursing
- Dosage Calculations
- Understanding Society
- Circulatory System
- Concepts of Pharmacology
- Hematologic Disorders
- Newborn Care
- Adulthood Growth and Development
- Disorders of Pancreas
- Postoperative Nursing
- Pregnancy Risks
- Neurological
- Postpartum Complications
- Noninfectious Respiratory Disorder
- Peripheral Nervous System Disorders
- Learning Pharmacology
- Prenatal Concepts
- Tissues and Glands
- Developmental Considerations
- Factors Influencing Community Health
- Childhood Growth and Development
- Prenatal and Neonatal Growth and Development
- Developmental Theories
- Basic
- Neonatal
- Pediatric
- Gastrointestinal
- Newborn Complications
- Labor Complications
- Fetal Development
- Terminology
- Labor and Delivery
- Postpartum Care
- Communication
- Basics of Mathematics
- Statistics
- Basics of Sociology
- Cardiovascular
- Shock
- Shock
- Disorders of the Posterior Pituitary Gland
- Endocrine
- Disorders of the Thyroid & Parathyroid Glands
- Liver & Gallbladder Disorders
- Lower GI Disorders
- Respiratory
- Delegation
- Perioperative Nursing Roles
- Acute & Chronic Renal Disorders
- Respiratory Emergencies
- Disorders of the Adrenal Gland
- Documentation and Communication
- Preoperative Nursing
- Legal and Ethical Issues
- Oncology Disorders
- Female Reproductive Disorders
- Musculoskeletal Trauma
- Renal Disorders
- Male Reproductive Disorders
- Sexually Transmitted Infections
- Infectious Respiratory Disorder
- Integumentary Disorders
- Emergency Care of the Trauma Patient
- Urinary Disorders
- Musculoskeletal Disorders
- EENT Disorders
- Neurological Emergencies
- Disorders of Thermoregulation
- Neurological Trauma
- Basics of NCLEX
- Integumentary Important Points
- Multisystem
- Test Taking Strategies
- Urinary System
- Emergency Care of the Neurological Patient
- Central Nervous System Disorders – Spinal Cord
- Respiratory System
- Emergency Care of the Respiratory Patient
- Cognitive Disorders
- Anxiety Disorders
- Depressive Disorders
- Trauma-Stress Disorders
- Substance Abuse Disorders
- Bipolar Disorders
- Psychotic Disorders
- Concepts of Mental Health
- Eating Disorders
- Personality Disorders
- Health & Stress
- Psychological Emergencies
- Somatoform Disorders
- Prioritization
- Community Health Overview
- Gastrointestinal Disorders
- Integumentary Disorders
- Respiratory Disorders
- Neurologic and Cognitive Disorders
- Renal and Urinary Disorders
- Infectious Disease Disorders
- EENT Disorders
- Hematologic Disorders
- Cardiovascular Disorders
- Musculoskeletal Disorders
- Endocrine and Metabolic Disorders
- Oncologic Disorders
- Behavior
- Emotions and Motivation
- Growth & Development
- Intelligence and Language
- Psychological Disorders
- State of Consciousness
- Note Taking
- Concepts of Population Health
- Basics of Human Biology