Toxicology (Part-11) Barbiturate Poisoning Symptoms and Treatment | Treatment of Barbiturate Poison

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Toxicology is a scientific discipline, overlapping with biology, chemistry, pharmacology, and medicine, that involves the study of the adverse effects of chemical substances on living organisms and the practice of diagnosing and treating exposures to toxins and toxicants. The relationship between dose and its effects on the exposed organism is of high significance in toxicology. Factors that influence chemical toxicity include the dosage, duration of exposure (whether it is acute or chronic), route of exposure, species, age, sex, and environment. Toxicology is a field of science that helps us understand the harmful effects that chemicals, substances, or situations, can have on people, animals, and the environment. Some refer to toxicology as the “Science of Safety” because as a field it has evolved from a science focused on studying poisons and adverse effects of chemical exposures, to a science devoted to studying safety.
Barbiturates are a class of sedative-hypnotic drugs. They are commonly used as antiepileptics (phenobarbital) and for the induction of general anaesthesia (thiopental). Some states administer barbiturates for physician-assisted suicide/euthanasia and use them for capital punishment by lethal injection. Their use in clinical practice has largely been replaced by benzodiazepines such as alprazolam, diazepam, and lorazepam due to the lower risk of overdose and available antidote to reverse toxicity. Barbiturates are used as a laboratory buffer and can be found in clinical and research laboratories.
Treatment of barbiturate toxicity remains supportive as there is no specific antidote for overdose. The first step in treatment, as with any overdose, is assessing the patient’s airway, breathing, and circulation. With significant sedation and respiratory depression, intubation and mechanical ventilation may become necessary. Early treatment with activated charcoal may be useful and can be given via nasogastric tube. Patients will likely need to be admitted or observed. During recovery, the patient should receive counselling about the dangers of barbiturate misuse. Long-term barbiturate use can cause tolerance and physical dependence. Therefore, withdrawal symptoms can occur with abrupt discontinuation.
Supportive Maintainance=
(1) gastric Lavage= Gastric lavage is a gastrointestinal decontamination technique that aims to empty the stomach of toxic substances by the sequential administration and aspiration of small volumes of fluid via an orogastric tube
(2) Activated Charcoal = Activated charcoal is a fine, odourless, black powder often used in emergency rooms to treat overdoses. Its toxin-absorbing properties have a wide range of medicinal and cosmetic uses, though none are scientifically proven. Superheating natural sources of carbon, such as wood, produces activated charcoal.
(3) Force Alkalosis of Urine= The aim of forced diuresis is to enhance urinary excretion of the poison by increasing urine volume per unit of time. It is achieved by means of intravenous administration of a compatible fluid. Nowadays, forced diuresis is almost always combined with manipulation of urine pH.
(4) Haemodilysis= Hemodialysis is a process of purifying the blood of a person whose kidneys are not working normally. Hemodialysis is a treatment to filter wastes and water from your blood, as your kidneys did when they were healthy. Hemodialysis helps control blood pressure and balance important minerals, such as potassium, sodium, and calcium, in your blood.
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