• The Korean Journal of Pharmacology
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• v.31 no.3
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• pp.271-278
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• 1995

The relative distribution ratio of barbiturates between hyarocarbon interior and surface region of outer monolayer of synaptosomal plasma membrane vesicles (RSPMV) isolated from rat whole brain was determined by employing the fluorescent probe technique. The two fluorescent probes N- octadecylnaphthyl-2-amine-6-sulfonic acid (ONS) and 12-(9-anthroyloxy) stearic acid (AS) were utilized as probes for hydrocarbon interior and surface of outer monolayer of RSPMV. respectively. The Stern-Volmer equation for fluorescent quenching was modified to calculate the relative distribution ratio. The analysis of preferential quenching of these probes by barbiturates indicates that pentobarbital, hexobarbital, amobarbital and phenobarbital are predominantly distributed on the surface region. whereas thiopental sodium has an accessibility to the hydrocarbon interior of the outer monolayer of the RSPMV. From these results, it is strongly suggested that the more effective penetration into the hydrocarbon interior of the outer monolayer of the membrane lipid bilayer could result in higher general anesthetic activity.

• The Korean Journal of Pain
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• v.19 no.2
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• pp.213-217
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• 2006

Although various treatments for complex regional pain syndrome (CRPS) have been proposed, no well recognized treatment for CRPS has been established. Herein, a case using barbiturate coma therapy for the refractory pain management of a 24-year-old male patient, who suffered from constant stabbing and burning pain, with severe touch allodynia in the left upper extremity following blunt trauma on his forearm is described. Interventional treatments, including permanent spinal cord stimulation and large doses of oral medications, were performed. However, the pain could not be controlled, which lead to frequent emergency room treatment for about 1 month prior to his therapy. He then underwent barbiturate coma therapy due to the uncontrollable pain, with repeated sedation therapy due to his outrageous behavior. His pain became increasingly tolerable and the allodynia was markedly decreased after 5 days of coma therapy.

• Journal of Korean Academy of Nursing Administration
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• v.16 no.1
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• pp.59-72
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• 2010

Purpose: This study is a descriptive research to analyze prognostic factors of barbiturate coma therapy (BCT) for severe brain damage patients, to develop a critical pathway (CP) based on the results of analysis and to examine the effect of its clinical application. Method: We analyzed medical records of 76 patients who received BCT for more than three days between January 1999 to July 2005. Based on the results of the analysis, we developed a CP and applied it to 12 people during August-December of 2005. Result: By application of BCT CP, the mortality rate decreased from 31.6% to 16.7%. It was found that the period of staying at ICU and total period of hospitalization were shortened by 2.78 (13.9%) days and 16.43 (29.4%) days, respectively. The Glasgow coma scale of the recovery group by CP application was 9.03 (4.64) at 72 hours post of BCT and 14.28 (1.82) at discharge from hospital, and DRS was 6.62 (6.38) points. Conclusion: By verifying clinical validity of the suggested CP, we believe that we have obtained visible effects standardizing the treatment pathway of BCT for brain damage patients.

• Toxicological Research
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• v.7 no.1
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• pp.29-35
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• 1991

Barbiturates are commonly abused tranquilizer and a rapid method to determine these drugs in biological samples is needed. In this study, was screened barbiturates in urine specimens by the fluorescence polarization immunoassay method(FPIA) and the positive samples were confirmed and identified by the more definitive GC/MS method. Fifteen positive smples which have barbiturate values higher than 0.5 ng/ml were analyzed by the GC/MS method. Eight samples were identified as phenobarbital and five samples were identified as crotilbarbitone.

• Archives of Pharmacal Research
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• v.13 no.3
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• pp.246-251
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• 1990

Intermolecular interaction between barbiturates and membrane components such as phospholipid and cholesterol were investigated on $^1$H-NMR spectra and infrared spectra. According to previous reports, barbiturates interacted with phospholipid through intermolecular hydrogen bonds. We also investigated thi observation using dipalmitoyl-phosphatidylcholine (DPPC) as phospholipid in deuterochloroform, and characterized quantitatively. Also, the observed drug could interact with cholesterol which is one of the major components of biomembranes through hydrogen bonds. It was the carbonyl groups of barbiturate and the hydroxyl group of cholesterol that formed hydrogen bond complex. In addition to spectroscopic studies, we investigated the direct effect of phenobarbital on lipid multibilayer vesicles, whose compositions were varied, by calorimetric method. Phenobarbital caused a reduction in the temperature of phase transition of vesicles. These studies may provided a basis for interpreting the mode of action of barbiturates.

• Journal of Korean Neurosurgical Society
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• v.44 no.3
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• pp.141-145
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• 2008

Objective : Barbiturate coma therapy (BCT) has been known to be an useful method to control increased intracranial pressure (IICP) refractory to medical and surgical treatments. We have used BCT for patients with severe IICP during the past 10 years, and analyzed our results with review of literatures. Methods : We analyzed 92 semicomatose or comatose patients with Glasgow coma scale (GCS) of 7 or less with severe IICP due to cerebral edema secondary to parenchymal damages irrespective of their causes. Forty patients who had received BCT with ICP monitoring from January 1997 to December 2006 were included in BCT group, and fifty-two patients who had been managed without BCT from January 1991 to December 1995 were divided into control group. We compared outcomes with Glasgow outcome scale (GOS) and survival rate between the two groups. Results : Good outcome (GOS=4 and 5) rates at 3-month after insult were 27.5% and 5.8% in BCT and control group, respectively (p<0.01). One-year survival rates were 35.9% and 12.5% in BCT and control group, respectively (p<0.01). In BCT group, the mean age of good outcome patients ($37.1{\pm}14.9$) was significantly lower than that of poor outcome patients ($48.1{\pm}13.5$) (p<0.05). Conclusion : With our 10-year experience, we suggest that BCT is an effective treatment method for severe IICP patients for better survival and GOS, especially for younger patients.

• The Korean Journal of Pharmacology
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• v.26 no.2
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• pp.209-217
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• 1990

Intramolecular excimer formation with 1,3-di(1-pyrenyl)propane (Py-3-Py) and fluorescence polarization with 1,6-diphenyl-1,3,5-hexatriene (DPH) were used to evaluate the effects of barbiturates on the bulk fluidity of the model membranes of phosphatidylethanolamine fraction of synaptosomal plasma membrane vesicles (SPMVPE) isolated from bovine cerebral cortex. In the SPMVPE, barbiturates decreased the excimer to monomer fluorescence intensity ratio (I'/I) of Py-3-Py and increased the fluorescence polarization (P), anisotropy (r), limiting anisotropy $(r_{8})$, order parameter (S) and rotational relaxation time $({\bar{P}})$ of DPH in a dose-dependent manner. The relative potencies of barbiturates to order the SPMVPE were in the order: pentobarbital > hexobarbital > amobarbital > phenobarbital. Hence, it is concluded that barbiturates have ordering effects on the SPMVPE. And the membrane-ordering potencies of barbiturates appear to be correlated with the potencies for enhancement of GABA-stimulated chloride influx and with the anesthetic effects of barbiturates.

• Korean Journal of Pharmacognosy
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• v.25 no.1
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• pp.1-10
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• 1994

The screening of 150 Chinese drugs which are most frequently prescribed in Korean traditional medicine showed that at least 30% of the drugs affected barbiturate-induced hypnosis. This effect was mainly attributable to the alteration of drug metabolism. Phytochemical works resulted in the isolation of furanocoumarins, lignans, sesquiterpenes and saponins as drug metabolism modifiers. The structure-activity relationship is discussed.

• Journal of Korean Neurosurgical Society
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• v.56 no.5
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• pp.448-450
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• 2014

Nefopam, a centrally acting analgesic, has been used to control postoperative pain. Reported adverse effects are anticholinergic, cardiovascular or neuropsychiatric. Neurologic adverse reactions to nefopam are confusion, hallucinations, delirium and convulsions. There are several reports about fatal convulsive seizures, presumably related to nefopam. A 71-year-old man was admitted for surgery for a lumbar spinal stenosis. He was administered intravenous analgesics : ketorolac, tramadol, orphenadrine citrate and nefopam HCl. His back pain was so severe that he hardly slept for several days; he even needed morphine and pethidine. At 4 days of administration of intravenous analgesics, the patient suddenly started generalized tonic-clonic seizures for 15 seconds, and subsequently, status epilepticus; these were not responsive to phenytoin and midazolam. After 3 days of barbiturate coma therapy the seizures were controlled. Convulsive seizures related to nefopam appear as focal, generalized, myoclonic types, or status epilepticus, and are not dose-related manifestations. In our case, the possibility of convulsions caused by other drugs or the misuse of drugs was considered. However, we first identified the introduced drugs and excluded the possibility of an accidental misuse of other drugs. Physicians should be aware of the possible occurrence of unpredictable and serious convulsions when using nefopam.

• The Korean Journal of Pharmacology
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• v.7 no.1
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• pp.21-27
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• 1971

The effects of 5 different drugs (amphetamine, caffeine, serotonin, sod. salicylate and pentazocine) on the duration of action of two barbiturates (thiopental and pentobarbital) and an intravenous anesthetic (propanidid) were determined in rats. Duration of action was determined by the time elapsing between loss and return of the righting reflexes. All drugs were injected intraperitoneally except propanidid which was administered by the intravenous route. Preliminary experiments indicated that at a dose of 40 mg/kg either of the two barbiturates or propanidid produced loss of the righting reflexes without death. At this dose, however, the duration of action of propanidid was extremely short. However, this dose was selected for subsequent studies. 1. At the dose employed amphetamine shortened the sleeping time of three compounds. 2. Caffeine and theophylline shortened the sleeping time of thiopental and prolonged the duration of action of pentobarbital. 3. Serotonin had no effect on duration of action of the barbiturates but prolonged the sleeping time produced by propanidid. 4. Sod. salicylate significantly prolonged the sleeping time of the barbiturates whereas pentazocine exhibited this effect only in relation to thiopental.