Which medications in the drug class Barbiturates are used in the treatment of MDMA Toxicity?

Updated: Dec 20, 2017
  • Author: In-Hei Hahn, MD, FACEP, FACMT; Chief Editor: Jeter (Jay) Pritchard Taylor, III, MD  more...
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Answer

Barbiturates

Class of anticonvulsants useful when phenytoin and benzodiazepines fail.

Phenobarbital (Luminal, Barbita, Solfoton)

Exhibits anticonvulsant activity in anesthetic doses. In status epilepticus, important to achieve therapeutic levels as quickly as possible. IV dose may require approximately 15 min to attain peak levels in brain.

If IM route is chosen, administer into areas such as one of the large muscles (eg, gluteus maximus, vastus lateralis, other areas with little risk of encountering a nerve trunk or major artery); permanent neurologic deficit may result from injection into or near peripheral nerves.

Restrict IV use to conditions in which other routes are not possible, either because patient is unconscious or because prompt action is required; if used to terminate generalized convulsive status epilepticus, administer up to 15-20 mg/kg.

Ventilation and intubation may be necessary; hypotension may require treatment; a trend exists in recommendations to use agents other than phenobarbital (propofol, midazolam, other barbiturates) for refractory status epilepticus.


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