Barbiturates and Barbiturate-like Drugs
巴比妥酸盐类和巴比妥酸盐样药物
Barbiturates and barbiturate-like drugs include phenobarbital (Solfoton, Luminal), and primidone (Mysoline). These drugs are associated with significant CNS depression.
巴比妥酸盐类和巴比妥酸盐样药物包括苯巴比妥（【奥】索夫通、鲁米那）和扑米酮（麦苏林）。这些药物都与重大的CNS抑制有相关性。 Therapeutic Actions and Indications 治疗作用和适应症
The barbiturates and barbiturate-type drugs inhibit impulse conduction in the ascending reticular activating system (RAS), depress the cerebral cortex, alter cerebellar function, and depress motor nerve output. They stabilize nerve membranes throughout the CNS directly by influencing ionic channels in the cell membrane, thereby decreasing excitability and hyperexcitability to stimulation. By decreasing conduction through nerve pathways, they reduce the tonic–clonic, muscular, and emotional responses to stimulation. Phenobarbital depresses conduction in the lower brainstem and the cerebral cortex and depresses motor conduction.
巴比妥酸盐类和巴比妥酸盐样药物抑制上行网状激活系统（RAS）的脉冲传导、压制大脑皮质、改变小脑功能、压制运动神经输出。药物稳定直接通过影响细胞膜离子通道稳定CNS神经膜，从而降低刺激的兴奋性和过度兴奋性。通过减少神经通路传导，药物减少刺激的强直-阵挛、肌肉和情感反应。苯巴比妥抑制下脑干和大脑皮质的传导，抑制运动传导。 Adverse Effects 不良效应
The most common adverse effects associated with barbiturates relate to CNS depression and its effects on body function: Depression, confusion, drowsiness, lethargy, fatigue, constipation, dry mouth, anorexia, cardiac arrhythmias and changes in blood pressure, urinary retention, and loss of libido. Because barbiturates and barbiturate-like drugs depress nerve function, they can produce sedation, hypnosis, anesthesia, and deep coma. The degree of depression is dose related. At doses below those needed to cause hypnosis, these drugs block seizure activity.
巴比妥酸盐类最普遍的不良效应都与CNS抑制及其对身体功能的影响有关：抑郁、意识错乱、瞌睡、倦怠、疲劳、便秘、口干、厌食、心律异常和血压变化、尿潴留及性欲缺乏。因为巴比妥酸盐类和巴比妥酸盐样药物压抑神经功能，这些药物可以产生镇静、催眠、麻醉和深度昏迷作用。压抑程度与剂量相关。剂量低于催眠所需时，这些药物可以阻断癫痫活动。
In addition, phenobarbital may be associated with physical dependence and withdrawal syndrome. The drug has also been linked to severe dermatological reactions and the development of drug tolerance related to changes in drug metabolism over time.
此外，苯巴比妥可能与躯体依赖和戒断综合征存在相关性。药物还与严重的皮肤病学反应和长期药物代谢相关的耐药性有联系。
★Vocabulary for Today ★
barbiturates – n. 巴比妥酸盐类
phenobarbital – n. 苯巴比妥
Solfoton – n. 【奥】索夫通
Luminal – n. 鲁米那
primidone – n. 扑米酮
Mysoline – n. 麦苏林
impulse conduction – 脉冲/冲动传导
ascending – a. 上午的，升的
RAS -- reticular activating system 网状激活系统
cerebral cortex – 大脑皮质
cerebellar – a. 小脑的
stabilize – v. 安定，稳定
ionic channels – 离子通道
nerve pathway – 神经通路
loss of libido – 性欲缺乏
physical dependence – 身体依赖
withdrawal syndrome – 戒断综合征
dermatological – a. 皮肤病学的
drug tolerance – 耐药性
(文中标记【奥】者为本站临时用名，只为方便复习记忆，不得作为临床用药依据)
1. A client with a history of abusing barbiturates abruptly stops taking the medication. The nurse should give priority to assessing the client for:
A. Depression and suicidal ideation
B. Tachycardia and diarrhea
C. Muscle cramping and abdominal pain
D. Tachycardia and euphoric mood 2. Select all that apply to the use of barbiturates in treating insomnia:
A. Barbiturates deprive people of NREM sleep
B. Barbiturates deprive people of REM sleep
C. When the barbiturates are discontinued, the NREM sleep increases.
D. When the barbiturates are discontinued, the REM sleep increases.
E. Nightmares are often an adverse effect when discontinuing barbiturates.
答案Answers 1. B. Tachycardia anddiarrhea Barbiturates create a sedative effect. When the client stops taking barbiturates, he will experience tachycardia, diarrhea, and tachypnea. Answer A is incorrect even though depression and suicidal ideation go along with barbiturate use; it is not the priority. Muscle cramps and abdominal pain are vague symptoms that could be associated with other problems. Tachycardia is associated with stopping barbiturates, but euphoria is not. 2. B, E, and E. Barbiturates deprive people of REM sleep. When the barbiturate is stopped and REM sleep once again occurs, a rebound phenomenon occurs. During this phenomenon, the persons dream time constitutes a larger percentage of the total sleep pattern, and the dreams are often nightmares.
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