Barbituric acid preparations

In acute poisoning with barbituric acid preparations (phenobarbital, barbamil, sodium barbital), drowsiness is noted, turning into stupor and more severe stupefaction, sometimes euphoria, like stupefaction with anxiety, delirious and amentic phenomena, pupil constriction, hyperthermia (to 39 °) ), disorders of cardiovascular activity, respiration. The reason for the development of substance abuse is most often the systematic intake of barbiturates with a gradual increase in doses. We had to observe cases of rapid addiction to barbiturates, due to their intoxicating and euphoric effects, among people who abuse alcohol or drugs. A predisposing factor is neurotization and psychopathization of personality, neurosis and psychopathic conditions in organic brain lesions. Barbiturate substance abuse, as noted by I.V. Strelchuk (1956), is usually combined with other substance abuse and drug addiction. It leads to toxic encephalopathy with marked impoverishment of all aspects of the personality: patients are apathetic, inactive, differ in a narrowed circle of interests, superficial and unproductive thinking, memory loss; they have an unstable mood with a reassessment of their own personality or anger, pessimism and suicidal thoughts. In a state of abstinence, manifestations of physical and mental dependence are expressed. There is a lack of appetite, insomnia, general tremor, irritability, pickiness, distrust and suspicion, delusional ideas of a relationship. Visual, tactile hallucinations are possible. Treatment involves a complete simultaneous break in taking drugs. Patients are prescribed detoxification and restorative therapy, antipsychotics and psychotherapy. Tranquilizers are widely used not only in psychiatry, but also in other areas of clinical medicine. Often they are used for self-medication. This is the basis for the occurrence of substance abuse conditions. The use of these drugs leads to the development of physical, often mental dependence. It becomes common to use tranquilizers to maintain an optimal psychophysical state, relieve emotional stress, increased excitability, anxiety, and improve sleep. A simultaneous overdose of tranquilizers can cause a state of tension, anxiety, anxiety and confusion, lethargy, lack of focus, difficulty in mental operations, indifference, drowsiness, or deep sleep with a transition to a soporious and coma state. Apparently, acute intoxication psychoses of delirious or acute paranoid and delirious-onyroid types can occur as individual reactions to some tranquilizers. Chronic intoxication with tranquilizers with pathological attraction in a hospital environment is practically not found, since doctors prescribe them very carefully. Among tranquilizers with increased toxicomanic ability, meprotan, chlozepide (chlordiazepoxide), nigrazepam (eunctin), sibazon (diazepam) and phenazepam (G. Ya. Avrutsky, A.A. Neduva, 1981; E.A. Babayan, M. X. Gonopolsky, 1981; P. Temkov, K. Kirov, 1971; G. Panaitescu, E. Popescu, 1976). Signs of chronic intoxication include a decrease in intellectual productivity, differentiation of emotions, increased irritability, depersonalization phenomena, ataxia, dysarthria. In the withdrawal syndrome, mental dependence predominates, headache, insomnia, weakness, lethargy, lack of thinking, mood instability, anger, depression with suicidal thoughts are noted. Treatment includes the simultaneous withdrawal of drugs, the appointment of detoxification and restorative therapy, antipsychotics and psychotherapy. There are indications of the occurrence of substance abuse as a result of systematic long-term use of melipramine, amitriptyline. Melipramine (imizine, tofranil) in the usual therapeutic dose can exacerbate the productive psychopathological symptoms of various mental illnesses, leading to a state of anxiety and anxiety. The toxic dose of this drug sometimes causes acute psychotic conditions with a change in consciousness, psychomotor agitation, hallucinatory and delusional symptoms (G. Ya. Avrutsky, A. A. Neduva, 1981; S. Puzynski, 1980). An overdose of amitriptyline more often gives a picture of stupor, and acute poisoning by MAO inhibitors (nialamide, etc.) – confusion with psychomotor agitation, hallucinations of an exogenous type. Toxic addiction to antidepressants is expressed by withdrawal symptoms in the form of anxiety, fear, insomnia with headache, nausea (S. Puzynski, 1980). Morphism and other types of pathological attraction to certain substances considered below belong to drug addiction. Morphine is one of the opium alkaloids, which also include codeine, papaverine, thebaine, etc. In medical practice, morphine, omnopon (pantopon), ethylmorphine hydrochloride, and the synthetic morphine-like drug promedol are used. Acute morphine poisoning is characterized first by euphoria and agitation, then by sharp weakness, dizziness, frequent urination, tachycardia, constricted pupils, drowsiness with a transition to a state of stupidity and coma. The physiological antidote of morphine is atropine. The constant use of morphine (most often to relieve pain) quickly leads to morphinism with an increase in the dose necessary for the patient, often exceeding many times the lethal one, with pronounced physical and mental dependence. I.V. Strelchuk (1956) distinguished the following forms of morphinism: 1) compensated (mild), in which patients are not impaired, their somatic state without significant deviations from the norm, withdrawal symptoms occur easily; 2) a subcompensated (moderate) form in which disability is reduced, cachexia, mild personality degradation, and withdrawal symptoms are severe; 3) decompensated (severe) form, when the disability is completely lost, there are pronounced signs of physical exhaustion and degradation of the person. Such a division makes it possible to determine the tactics of treatment: start it with the complete discontinuation of the drug or with a stepwise reduction in its dose. According to our observations, in the first place in the frequency of detection are compensated, then – subcompensated and decompensated forms of morphinism. Predisposing factors for the development of morphinism are diseases with severe pain syndrome, in which it is necessary to administer a drug for a long time, as well as psychopathy and other types of neuropsychic instability. Sometimes drugs are used out of curiosity.

local_offerevent_note October 12, 2019

account_box admin

Leave a Reply

Your email address will not be published. Required fields are marked *