80345 Barbiturates

Name of the Procedure:

Barbiturates Administration

Summary

Barbiturates are a class of drugs that act as central nervous system depressants. They are used in medical practice to manage anxiety, insomnia, and seizure disorders by slowing down brain activity.

Purpose

Barbiturates are primarily used to treat severe anxiety, sleep disorders, and to control seizures in epilepsy. They aim to induce sedation or sleep, providing relief from distress and preventing seizure activity.

Indications

• Anxiety disorders
• Severe insomnia
• Epileptic seizures
• Preoperative anxiety and sedation
• Status epilepticus (a severe, continuous form of seizure)

Patient criteria:

• Diagnosis of conditions treatable by barbiturates
• No history of hypersensitivity to barbiturates

Preparation

• Fasting may be required if the barbiturates are being administered for surgical sedation.
• Medication history review to avoid possible drug interactions.
• Blood tests or liver function tests to ensure the patient can safely metabolize the drug.

Procedure Description

1. Patient assessment including history and vital signs.
2. Informed consent obtained.
3. Medication drawn and checked for correct dosage.
4. Administration routes can include oral, intravenous, or intramuscular.
   • Oral: Swallowed in tablet or liquid form.
   • Intravenous (IV): Directly injected into the bloodstream.
   • Intramuscular (IM): Injected into a large muscle.
5. Continuous monitoring (e.g., pulse, respiratory rate, blood pressure) during administration if required for sedation.

Duration

• Oral: Begins within 30 minutes, lasts 3-6 hours.
• IV: Immediate effect, lasts 1-2 hours.
• IM: Begins within 15-30 minutes, lasts 3-4 hours.

Setting

• Hospital, outpatient clinic, or surgical center.

Personnel

• Physician or nurse practitioner (prescribe and oversee administration)
• Registered nurse or licensed practical nurse (administer the drug)
• Anesthesiologist may be involved if used for surgical sedation

Risks and Complications

• Common: Drowsiness, dizziness, confusion.
• Rare: Respiratory depression, dependency, overdose leading to coma or death.
• Possible complications: Allergic reaction, withdrawal symptoms, tolerance build-up.

Benefits

• Effective management of anxiety, insomnia, and seizures.
• Relief from severe distress and prevention of seizure-related injuries.
• Results can be observed within minutes to hours depending on the administration route.

Recovery

• Patient should rest post-administration.
• Avoid operating heavy machinery or driving until the effects have worn off.
• Follow-up appointments to monitor response and adjust dosage if necessary.
• Gradual tapering for long-term users to avoid withdrawal symptoms.

Alternatives

• Other anxiolytics (benzodiazepines)
• Non-pharmacological approaches (psychotherapy, cognitive-behavioral therapy)
• Antiepileptic drugs (valproate, carbamazepine) for seizure control

Patient Experience

• Patients might feel drowsy or relaxed.
• Some may experience mild side effects like headache or nausea.
• Pain management includes routine analgesics if needed.
• Comfort measures include a quiet environment and supportive care during recovery.