TY - CHAP M1 - Book, Section TI - Barbiturates A1 - Gresham, Chip A1 - LoVecchio, Frank A2 - Tintinalli, Judith E. A2 - Stapczynski, J. Stephan A2 - Ma, O. John A2 - Yealy, Donald M. A2 - Meckler, Garth D. A2 - Cline, David M. PY - 2016 T2 - Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 8e AB - Barbiturate toxicity has historically been associated with the highest risk of morbidity and mortality among all sedative-hypnotics. Barbiturates are still the most common class of antiepileptic drugs used in developing countries, but their use is declining due to the introduction of safer, less toxic sedative-hypnotics, such as benzodiazepines, and second-generation anticonvulsants.1 Status epilepticus,2 severe ethanol and sedative withdrawal syndromes,3,4,5 and toxicologic seizures6 are typically managed with benzodiazepines, but barbiturates have a useful role as a second-line agent. They are still used in combination drugs (i.e., butalbital) and alone (i.e., secobarbital) for the treatment of tension and migraine headaches,7,8 although the efficacy of either is controversial.9 Barbiturates are used in the pharmacologic management of refractory intracranial hypertension from focal and diffuse brain injury, but evidence of improved outcomes has been modest.10 SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/03/28 UR - accessemergencymedicine.mhmedical.com/content.aspx?aid=1121512617 ER -