Short-acting barbiturate overdosage. Correlation of intoxication score with serum barbiturate concentration

Abstract

The only consistent clinical features in 1140 cases of short-acting barbiturate overdosage were CNS depression with and without respiratory depression, hypotension and hypothermia. Seven states of intoxication were defined and scored, using a modification of the Glasgow coma scale. There was a linear correlation between the intoxication score and the mean serum short-acting barbiturate concentration in 688 cases tested. The following serum short-acting barbiturate concentrations may be expected for nonaddicted patients having no medical complications contributing to cerebral depression and intoxicated with only short-acting barbiturate: < 6 .mu.g/ml, alert; 8 .+-. 2 .mu.g/ml, drowsy; 14 .+-. 3 .mu.g/ml, stuporous; 18 .+-. 2 .mu.g/ml, coma 1; 22 .+-. 2 .mu.g/ml, coma 2; 26 .+-. 2 .mu.g/ml, coma 3 and 34 .+-. 6 .mu.g/ml, coma 4. The serum concentrations will be lower if the patient has ingested an additional sedative or has a complication contributing to cerebral depression, and higher if the patient is addicted to a sedative-hypnotic drug.