"Barbiturate overdose"

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                            1
                            2020Ministry of Health, Singapore
                            Trip Score
                            NarrativeNarrative based
                            EvidenceEvidence based
                            ?
                            2
                            2018CandiEM
                            ) dose is excreted unchanged through the kidney. * Barbiturates cross the placenta with fetal levels approaching those of the mother. They are also excreted in low concentration in breast milk. Use during pregnancy is associated with birth defects (category D).[4] What are the clinical symptoms of barbiturate overdose?Mild toxicity * Drowsiness * slurred speech * Ataxia * unsteady gait !! * Life threat = respiratory depression * Hypotension w/ normal or increased heart rate. * Watch out for noncardiogenic pulmonary edema & aspiration pneumonitis***Note: Barbiturate withdrawal syndrome includes: * Tremors * Hallucinations * Seizures * delirium (similar to the delirium tremens of ethanol withdrawal)[5] How are barbiturate overdoses managed? Investigations / Supportive care / Invasive
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                            3
                            2016CandiEM
                            that in cases where a physician disagrees with an SDM about providing full resuscitative care to a patient, and pending further attempts at conflict resolution, they should provide resuscitation – “unless the patient’s condition will prevent the intended physiologic goals of CPR (i.e., providing oxygenated blood flow to the heart and brain) from being achieved18.”In some cases, a massive barbiturate overdose
                            4
                            2020Medscape Pediatrics
                            * * Cerebral degenerative disease * * Tumor * * Toxins * * Idiopathic Toxins and medications that can cause SE include the following: * * Topical anesthetics (eg, lidocaine) * * Anticonvulsant overdose * * Camphor * * Hypoglycemic agents (eg, insulin, ethanol) * * Carbon monoxide * * Cyanide * * Heavy metals (eg, lead
                            5
                            2016PloS one
                            %) and aspiration pneumonitis (29%). The top three major classes consisted of benzodiazepines (79%), new-generation antidepressants (25%), and barbiturates/non-barbiturates (23%). Barbiturate overdose was independently associated with increased odds of both prolonged ICU stay (8% vs. 17%; odds ratio [OR], 2.97; 95% confidence interval [CI], 1.60-5.55) and aspiration pneumonitis (8% vs. 24%; OR, 3.83; 95% CI, 2.18
                            6
                            , then the abdomen was closed and a 4-h reperfusion followed. All animals were euthanized by barbiturate overdose (150 mg/kg pentobarbital sodium, i.v.) for tissue collection, and the SMA was isolated via median abdominal incision. Intestinal histologic injury was observed. Malondialdehyde (MDA), myeloperoxidase (MPO) and tumor necrosis factor (TNF)-α concentrations in intestinal tissue were measured
                            7
                            for propofol is Diprivan.Previous Next: PrognosisWith early supportive care, overall in-hospital mortality rates from barbiturate poisoning are less than 0.5-2%.Fatality associated with barbiturate overdose is rare, but complications are abundant. [15] Morbidity includes immunosuppression with frequent nosocomial infections such as pneumonia, acute respiratory distress syndrome (ARDS), shock, hypoxic damage induce seizures that the barbiturates are intended to treat. [14] Pulmonary effectsBarbiturates can cause a depression of the medullary respiratory center and induce a respiratory depression. Patients with underlying chronic obstructive pulmonary disease (COPD) are more susceptible to these effects, even at doses that would be considered therapeutic in healthy individuals. Fatality from barbiturate
                            8
                            * * Cerebral degenerative disease * * Tumor * * Toxins * * Idiopathic Toxins and medications that can cause SE include the following: * * Topical anesthetics (eg, lidocaine) * * Anticonvulsant overdose * * Camphor * * Hypoglycemic agents (eg, insulin, ethanol) * * Carbon monoxide * * Cyanide * * Heavy metals (eg, lead
                            9
                            * * Cerebral degenerative disease * * Tumor * * Toxins * * Idiopathic Toxins and medications that can cause SE include the following: * * Topical anesthetics (eg, lidocaine) * * Anticonvulsant overdose * * Camphor * * Hypoglycemic agents (eg, insulin, ethanol) * * Carbon monoxide * * Cyanide * * Heavy metals (eg, lead
                            10
                            2014eMedicine Pediatrics
                            * * Cerebral degenerative disease * * Tumor * * Toxins * * Idiopathic Toxins and medications that can cause SE include the following: * * Topical anesthetics (eg, lidocaine) * * Anticonvulsant overdose * * Camphor * * Hypoglycemic agents (eg, insulin, ethanol) * * Carbon monoxide * * Cyanide * * Heavy metals (eg, lead
                            11
                            for propofol is Diprivan.Previous Next: PrognosisWith early supportive care, overall in-hospital mortality rates from barbiturate poisoning are less than 0.5-2%.Fatality associated with barbiturate overdose is rare, but complications are abundant. [15] Morbidity includes immunosuppression with frequent nosocomial infections such as pneumonia, acute respiratory distress syndrome (ARDS), shock, hypoxic damage induce seizures that the barbiturates are intended to treat. [14] Pulmonary effectsBarbiturates can cause a depression of the medullary respiratory center and induce a respiratory depression. Patients with underlying chronic obstructive pulmonary disease (COPD) are more susceptible to these effects, even at doses that would be considered therapeutic in healthy individuals. Fatality from barbiturate
                            12
                            2014eMedicine Pediatrics
                            * * Cerebral degenerative disease * * Tumor * * Toxins * * Idiopathic Toxins and medications that can cause SE include the following: * * Topical anesthetics (eg, lidocaine) * * Anticonvulsant overdose * * Camphor * * Hypoglycemic agents (eg, insulin, ethanol) * * Carbon monoxide * * Cyanide * * Heavy metals (eg, lead
                            13
                            2014eMedicine.com
                            for propofol is Diprivan.Previous Next: PrognosisWith early supportive care, overall in-hospital mortality rates from barbiturate poisoning are less than 0.5-2%.Fatality associated with barbiturate overdose is rare, but complications are abundant. [15] Morbidity includes immunosuppression with frequent nosocomial infections such as pneumonia, acute respiratory distress syndrome (ARDS), shock, hypoxic damage induce seizures that the barbiturates are intended to treat. [14] Pulmonary effectsBarbiturates can cause a depression of the medullary respiratory center and induce a respiratory depression. Patients with underlying chronic obstructive pulmonary disease (COPD) are more susceptible to these effects, even at doses that would be considered therapeutic in healthy individuals. Fatality from barbiturate
                            14
                            2014eMedicine.com
                            for propofol is Diprivan.Previous Next: PrognosisWith early supportive care, overall in-hospital mortality rates from barbiturate poisoning are less than 0.5-2%.Fatality associated with barbiturate overdose is rare, but complications are abundant. [15] Morbidity includes immunosuppression with frequent nosocomial infections such as pneumonia, acute respiratory distress syndrome (ARDS), shock, hypoxic damage induce seizures that the barbiturates are intended to treat. [14] Pulmonary effectsBarbiturates can cause a depression of the medullary respiratory center and induce a respiratory depression. Patients with underlying chronic obstructive pulmonary disease (COPD) are more susceptible to these effects, even at doses that would be considered therapeutic in healthy individuals. Fatality from barbiturate
                            15
                            that were regularly prescribed at that time. Unlike barbiturates, overdoses of thalidomide did not lead to coma. Thalidomide was especially recommended for pregnant women in whom it was used to relieve morning sickness.Then, at the beginning of the 1960s, obstetricians began to see a sharp increase in cases of severely malformed arms and legs in newborn babies. This previously rare condition results
                            16
                            1977NHS Economic Evaluation Database.
                            Review Analysis
                            Appears Promising
                            ?
                            . Study populationPatients with barbiturate overdose, polyradiculitis, multiple trauma, abdominal catastrophe,or hepato-renal failure receiving intensive care treatment . ..
                            17
                            Persistence of chloramphenicol residues in calf tissues. Twenty-one 5 to 18 day old calves were administered 11 mg chloramphenicol in propylene glycol per kg body weight intramuscularly twice daily for three days. Groups of calves were euthanized with a barbiturate overdose at 5, 21, 42 and 70 days after the last dose was administered. Serum, kidney, analyzed for the drug using a quantitative gas
                            18
                            1978British medical journal
                            Mortality among drug addicts in Greater London. During January 1970 to December 1974, 134 deaths in people aged 10-50 years investigated by coroners in Greater London were recorded as being due to drug addiction. Over three-quarters of the addicts were under 30, and 105 (78%) were male; 55 (41%) were unknown to the Home Office. Barbiturate overdose accounted for over half of the deaths, though
                            19
                            1970Journal of Clinical Pathology
                            Barbiturate blood levels found at necropsy in proven cases of acute barbiturate poisoning In order to determine whether blood barbiturate levels could be used to ascertain that death had been caused by barbiturate overdose, samples of blood from 128 subjects of coroners' necropsies were examined for barbiturate content. Sixty of these were well authenticated cases of barbiturate overdosage