RT Book, Section 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. SR Print(0) ID 1121512617 T1 Barbiturates T2 Tintinalli’s Emergency Medicine: A Comprehensive Study Guide, 8e YR 2016 FD 2016 PB McGraw-Hill Education PP New York, NY SN 9780071794763 LK accessemergencymedicine.mhmedical.com/content.aspx?aid=1121512617 RD 2024/11/11 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