Barbiturates: PharmacokineticsBarbiturates: Pharmacokinetics•Well absorbed •Reaching peak in 20 – 60 minutes•Metabolized in the liver•Excreted in the urine•Lipid soluble, pass to placenta
Barbiturates: Contraindications and CautionsBarbiturates: Contraindications and Cautions•Allergy to any barbiturate•Previous history of addiction to sedative–hypnotic drugs•Latent or manifest porphyria (accumulation of chemical substance) – can exacerbate•Marked hepatic impairment or nephritis•Respiratory distress or severe respiratory dysfunction- CNS depression makes it worse•Pregnancy – congenital abn. •Caution in people with acute or chronic pain – can mask symptoms, with seizures (abrupt withdrawal can exacerbate), and with hepatic/cardiac/respiratory diseases.
Barbiturates: Drug-to-Drug InteractionsBarbiturates: Drug-to-Drug Interactions•Increase CNS depression when given with alcohol, antihistamines, and other tranquilizers•Altered response to phenytoin•MAO cause increase serum levels and effect•Decrease effectiveness of the following drugs: anticoagulants, digoxin, tricyclic antidepressants, corticosteroids, oral contraceptive
Nursing Considerations for Barbiturates Nursing Considerations for Barbiturates •Assessment: History and Physical Exam•Nursing Diagnosis- don’t admin intra-arterially, don’t mix, stand by – life support equipment•Implementation•Evaluation