BARBITURATE INTOXICATION

Barbiturate poisoning is the most common cause of brain disorder due to toxic conditions. It is also the toxic disorder which most frequently leads to death.Excessive amounts of drugs are taken for many purposes: to relieve anxiety, induce sleep, reinforce or substitute for narcotics, reduce tension after alcoholic debauches, or simply for kicks. Death may occur from accidental as well as deliberate overdosage, since the person who takes one or two pills as a sedative may become so mentally confused that he will take several more without realizing it. Sudden withdrawal of the drug after long-continued use may also result in death. Acute barbiturate intoxication may take a mild, moderate, or severe form. In the mild form respiration and blood pressure are unaffected, but the individual becomes mentally confused, loses emotional control and laughs or cries without provocation. In the moderate state reflexes and respiration are slowed, and he becomes sleepy and hard to arouse. The severe state is characterized by deep coma, absence of all reflexes, periodic respiration, and symptoms of shock.Treatment of the first two stages of barbiturate intoxication is aimed at eliminating the drug from the system and keeping the patient from lapsing into sleep or coma. To keep him awake he is usually held up and walked about. If he falls into a deep stupor, emergency measures such as plasma expanders and artificial respiration will be required to maintain life. During recovery, the patient goes through a period of delirium which requires continuous nursing. In contrast to these acute cases, chronic intoxication occurs in constant users of barbiturates. Here the symptoms are impaired thinking and judgment, general mental confusion, defective reflexes, and poor motor coordination. Sudden withdrawal of the drug may be dangerous to life, since it is followed by extreme weakness, delirium, severe tremors, and often convulsions. Gradual withdrawal requires constant supervision and nursing.