Butabarbital Adverse Reactions
- acneiform rash
- anxiety
- bleeding
- bradycardia
- bullous rash
- depression
- diarrhea
- dizziness
- drowsiness
- exfoliative dermatitis
- fever
- headache
- hypotension
- irritability
- lethargy
- maculopapular rash
- miosis
- mydriasis
- nausea/vomiting
- nystagmus
- osteopenia
- photosensitivity
- physiological dependence
- ptosis
- purpura
- Stevens-Johnson syndrome
- toxic epidermal necrolysis
- urticaria
- vertigo
- weakness
- withdrawal
Butabarbital Adverse Reactions
CNS-depressant effects, including drowsiness, dizziness, lethargy, headache, vertigo, severe depression, anxiety, weakness, and irritability, can develop during therapy with butabarbital. Hypnotic doses produce residual sedation, and distortions of mood and impairment of motor skills can last for several hours. Patients should be warned of possible adverse effects, especially patients undertaking activities requiring mental alertness. Children and geriatric patients can experience more reactions. Some children respond with paradoxical excitement, and geriatric patients have suffered excitement, depression, or confusion.
Butabarbital can produce hypotension, sinus bradycardia, and vasodilation, which can lead to circulatory collapse.
Maculopapular rash or urticaria may not be serious side effects, but these reactions can precede more serious effects leading to exfoliative dermatitis, bullous rash, Stevens-Johnson syndrome, or toxic epidermal necrolysis so they should be investigated promptly. Other dermatologic effects include photosensitivity, acneiform rash, and purpura. Discontinuation of the drug may not be sufficient to reverse cutaneous reactions because of the slow metabolism and excretion of butabarbital.
Ocular adverse reactions with barbiturates occur most commonly after chronic use or toxic doses. Miosis is seen most frequently, but mydriasis predominates during toxic states. Disturbances in ocular movement may be seen with weakness of the extraocular muscles and nystagmus. Ptosis has been reported after chronic use.
GI effects, such as nausea/vomiting, diarrhea, and constipation, generally are not severe with butabarbital. Severity of reactions can be minimized by administering the drug with a large quantity of water or with food.
Osteopenia can be induced by barbiturates, especially during long-term use. Unusual weight loss, bone pain or tenderness, or muscle weakness should be investigated.
Blood dyscrasias can occur. Regular blood tests should be undertaken if barbiturates are to be used for long-term therapy. Symptoms such as unusual tiredness or weakness, unusual bleeding or bruising, and unexplained sore throat or fever should be investigated promptly.
Long term administration of butabarbital, amobarbital, pentobarbital, or secobarbital can result in tolerance, physiological dependence, and psychological dependence. Symptoms of withdrawal usually appear within 8 - 12 hours of discontinuing the drug and may include mild symptoms such as weakness, anxiety, muscle twitches, insomnia, nausea/vomiting, postural hypotension, and/or weight loss. Severe symptoms include hallucinations, delirium, and seizures. Seizures may occur within 16 hours or up to 5 days after the last dose and are similar to grand mal seizures. Cardiovascular collapse has occurred during barbiturate withdrawal. Withdrawal symptoms may also be present in neonates born to women receiving bariturated during the last trimester of pregnancy. Neonatal symptoms include hyperactivity, restlessness, disturbed sleep, tremor, and hyperreflexia. Treatment of withdrawal is usually achieved by administering phenobarbital and gradually tapering the dose downward.
[ Last revised: 5/31/2002 ]
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