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Barbiturates were
first introduced for medical use in the early 1900s. More than 2,500
barbiturates have been synthesized, and at the height of their popularity,
about 50 were marketed for human use. Today, about a dozen are in medical use.
Barbiturates produce a wide spectrum of central nervous system depression, from
mild sedation to coma, and have been used as sedatives, hypnotics, anesthetics,
and anticonvulsants. The primary differences among many of these products are
how fast they produce an effect and how long those effects last. Barbiturates
are classified as ultrashort, short, intermediate, and long-acting.
The
ultrashort-acting barbiturates produce anesthesia within about one minute after
intravenous administration. Those in current medical use are the Schedule IV
drug methohexital (Brevital®), and the Schedule III drugs thiamyl
(Surital®) and thiopental (Pentothal®). Barbiturate abusers prefer the
Schedule II short-acting and intermediate-acting barbiturates that include
amobarbital (Amyta®), pentobarbital (Nembutal®), secobarbital
(Seconal®), and Tuinal (an amobarbital/secobarbital combination product).
Other short and intermediate-acting barbiturates are in Schedule III and
include butalbital (Fiorina®), butabarbital (Butisol®), talbutal
(Lotusate®), and aprobarbital (Alurate®). After oral administration,
the onset of action is from 15 to 40 minutes, and the effects last up to six
hours. These drugs are primarily used for insomnia and preoperative sedation.
Veterinarians use pentobarbital for anesthesia and euthanasia.
Long-acting
barbiturates include phenobarbital (Luminal®) and mephobarbital
(Mebaral®), both of which are in Schedule IV. Effects of these drugs are
realized in about one hour and last for about 12 hours, and are used primarily
for daytime sedation and the treatment of seizure disorders.
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