TREATMENT OF ACUTE BARBITURATE POISONING

Abstract

SummaryAfter a short survey of the pharmacological properties of barbiturates and of the clinical signs of acute barbiturate intoxication, the authors review the different methods of treatment in use.Gastric lavage and administration of classical central analeptics are actually abandoned. The use of bemegride is limited to a few rare cases of respiratory depression of central origin.The modern treatment of acute barbiturate intoxication is essentially based on the Scandinavian method of reanimation and of the alkalinisation of plasma and urine by the method of Mollaret.The aim of the reanimation is to maintain within physiological limits of respiratory, cardiovascular and renal functions until the patient awakes, to prevent secondary infection and to ensure an adequate intake of liquids, calories and electrolytes. The primordial importance of the reanimation is actually everywhere admitted. The introduction of this symptomatic treatment has permitted to reduce the mortality of acute barbiturate intoxication to less than 3 %.Plasma and urine alkalinisation accelerates the renal output of the barbiturate. The duration of the coma is therefore significantly reduced.