Barbitol
Generic Name
Barbit
Manufacturer
MediPharma Ltd.
Country
Bangladesh
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Description
Overview of the medicine
Barbit is a central nervous system depressant belonging to the barbiturate class. It acts as a general depressant, producing a wide range of CNS depression from mild sedation to general anesthesia. It is used in the short-term treatment of insomnia, for relief of anxiety, and as an anticonvulsant in specific conditions.
Uses & Indications
Dosage
Adults
For insomnia: 50-100 mg orally at bedtime. For anxiety: 15-30 mg, 2-3 times daily. Dosage must be individualized.
Elderly
Lower doses are recommended, starting with half the adult dose, due to increased sensitivity and slower metabolism.
Renal_impairment
Use with caution; dose reduction may be necessary. Monitoring of renal function is advised.
How to Take
Oral tablets/capsules can be taken with or without food. Injections are administered intravenously or intramuscularly by a healthcare professional.
Mechanism of Action
Barbiturates bind to specific sites on the GABA-A receptor complex, enhancing the inhibitory effects of GABA. They prolong the duration of chloride channel opening, leading to hyperpolarization of the neuronal membrane and decreased neuronal excitability.
Pharmacokinetics
Onset
Onset of action is typically 30-60 minutes orally, much faster intravenously.
Excretion
Mainly excreted by the kidneys as inactive metabolites; a small portion may be excreted unchanged.
Half life
Variable, depending on the specific barbiturate; generally intermediate-acting (e.g., 10-60 hours).
Absorption
Readily absorbed from the gastrointestinal tract.
Metabolism
Primarily metabolized in the liver by microsomal enzyme systems.
Side Effects
Contraindications
- Known hypersensitivity to barbiturates
- History of acute intermittent porphyria
- Severe respiratory insufficiency
- Severe liver or kidney impairment
- Untreated pain (may mask symptoms)
Drug Interactions
Alcohol
Increased CNS depression, respiratory depression, hypotension.
MAO Inhibitors
Enhanced and prolonged effects of barbiturates due to inhibited metabolism.
Oral Anticoagulants
Barbiturates may decrease anticoagulant effect by inducing hepatic enzymes.
Oral Contraceptives
Reduced efficacy of oral contraceptives due to enzyme induction.
Other CNS Depressants (e.g., benzodiazepines, opioids)
Potentiation of sedative and respiratory depressant effects.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
Symptoms: Severe CNS depression, respiratory depression, hypotension, hypothermia, coma, shock, and death. Management: Primarily supportive care, maintaining airway and ventilation, hemodynamic support, gastric lavage/activated charcoal if recent ingestion. No specific antidote.
Pregnancy & Lactation
Pregnancy: Category D. Barbiturates can cause fetal harm, including withdrawal symptoms in neonates if used during pregnancy. Lactation: Excreted into breast milk and may cause sedation in the infant. Use is generally not recommended during pregnancy or lactation unless clearly necessary and benefits outweigh risks.
Side Effects
Contraindications
- Known hypersensitivity to barbiturates
- History of acute intermittent porphyria
- Severe respiratory insufficiency
- Severe liver or kidney impairment
- Untreated pain (may mask symptoms)
Drug Interactions
Alcohol
Increased CNS depression, respiratory depression, hypotension.
MAO Inhibitors
Enhanced and prolonged effects of barbiturates due to inhibited metabolism.
Oral Anticoagulants
Barbiturates may decrease anticoagulant effect by inducing hepatic enzymes.
Oral Contraceptives
Reduced efficacy of oral contraceptives due to enzyme induction.
Other CNS Depressants (e.g., benzodiazepines, opioids)
Potentiation of sedative and respiratory depressant effects.
Storage
Store below 30°C in a dry place, protected from light and moisture. Keep out of reach of children.
Overdose
Symptoms: Severe CNS depression, respiratory depression, hypotension, hypothermia, coma, shock, and death. Management: Primarily supportive care, maintaining airway and ventilation, hemodynamic support, gastric lavage/activated charcoal if recent ingestion. No specific antidote.
Pregnancy & Lactation
Pregnancy: Category D. Barbiturates can cause fetal harm, including withdrawal symptoms in neonates if used during pregnancy. Lactation: Excreted into breast milk and may cause sedation in the infant. Use is generally not recommended during pregnancy or lactation unless clearly necessary and benefits outweigh risks.
Frequently Asked Questions
Common questions about this medicine
Pack Sizes
Shelf Life
24 to 36 months from manufacturing date
Availability
Hospital pharmacies and specialized drug stores
Approval Status
Approved, but highly regulated due to abuse potential
Patent Status
Off-patent
WHO Essential Medicine
YesClinical Trials
Extensive clinical data exists for the barbiturate class, demonstrating efficacy in sedation, hypnosis, and seizure control, but also highlighting risks of dependence and respiratory depression. Specific trials for a generic 'Barbit' would reflect the standard profile.
Lab Monitoring
- For prolonged therapy: Periodic monitoring of complete blood count (CBC), liver function tests (LFTs), and kidney function tests (KFTs) is recommended.
- Therapeutic drug monitoring may be useful for anticonvulsant use.
Doctor Notes
- Caution with elderly, debilitated patients, and those with hepatic/renal impairment.
- Monitor for signs of dependence and respiratory depression.
- Educate patients on the dangers of concomitant alcohol use and abrupt discontinuation.
- Not recommended for chronic pain management.
Patient Guidelines
- Take exactly as prescribed by your doctor and do not exceed the recommended dose.
- Do not stop taking this medicine abruptly, especially after prolonged use, as it may cause withdrawal symptoms.
- Avoid alcohol and other CNS depressants while on this medication.
- This medicine may cause drowsiness; avoid driving or operating heavy machinery.
- Report any unusual side effects or signs of dependence to your doctor immediately.
Missed Dose Advice
If a dose is missed, take it as soon as you remember, unless it is almost time for your next dose. Do not double the dose to catch up. For sleep, if you remember late, skip the dose to avoid next-day drowsiness.
Driving Precautions
Barbit can cause significant drowsiness, dizziness, and impaired judgment. Patients should be advised not to drive, operate machinery, or engage in activities requiring mental alertness until they know how the drug affects them.
Lifestyle Advice
- Maintain a regular sleep schedule to help manage insomnia naturally.
- Avoid caffeine and stimulants, especially in the evening.
- Engage in stress-reduction techniques.
- Do not share this medication with others.
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