Barbiturate Poisoning

• Aka Goofballs, Red devils
• Action
  • Acts on GABA - BZD receptor
  • Potentiate GABAergic inhibition
• Metabolism
  • Absorption ↑ by empty stomach, alcohol
  • Widely distributed
  • Metabolised in Liver

• Postmortem
  • Features of Asphyxia
• Mostly suicidal
• Automatism - Patient forgets and takes repeated doses
• Thiopental & Amobarbital
  • Used as Truth Serum

FM & Toxicology - Gautam Biswas - 2nd edition Page No 493

• Drowsiness
• Irregular respiration
• Barbiturate blisters
  • Friction areas like axilla, knee, calf, interdigital clefts
• Hypothermia
• Bronchopneumonia

• Quanitfy serum concentrations
• ABC support
• Decontamination
  • KMnO4
  • Activated Charcoal
• Forced Alakaline Diuresis
  • With NaHCO3
  • Not effective for Ultra-short acting drugs
• Hemodialysis
  • Treat hypothermia