Barbiturate: Difference between revisions

Barbiturates induce a number of hepatic [[Cytochrome P450|CYP]] enzymes (most notably [[CYP2C9]], [[CYP2C19]], and [[CYP3A4]]),<ref>{{cite web|url=https://livertox.nlm.nih.gov/Barbiturates.htm|title=Livertox|access-date=21 June 2019|archive-date=2 July 2019|archive-url=https://web.archive.org/web/20190702153655/https://livertox.nlm.nih.gov/Barbiturates.htm|url-status=dead}}</ref> leading to exaggerated effects from many [[prodrug]]s and decreased effects from drugs which are metabolized by these enzymes to inactive metabolites. This can result in fatal overdoses from drugs such as [[codeine]], [[tramadol]], and [[carisoprodol]], which become considerably more potent after being metabolized by CYP enzymes. Although all known members of the class possess relevant enzyme induction capabilities, the degree of induction overall as well as the impact on each specific enzyme span a broad range, with phenobarbital and secobarbital being the most potent enzyme inducers and butalbital and talbutal being among the weakest enzyme inducers in the class.

 

 

People who are known to have killed themselves by barbiturate overdose include [[Stefan Zweig]], [[Charles Boyer]], [[Ruan Lingyu]], [[Dalida]], [[The Singing Nun|Jeannine Deckers]], [[Felix Hausdorff]], [[Abbie Hoffman]], [[Phyllis Hyman]], [[C. P. Ramanujam]], [[George Sanders]], [[Jean Seberg]], [[Lupe Vélez]] and the members of [[Heaven's Gate (religious group)|Heaven's Gate]] cult. Others who have died as a result of barbiturate overdose include [[Pier Angeli]], [[Brian Epstein]], [[Judy Garland]], [[Jimi Hendrix]], [[Marilyn Monroe]], [[Inger Stevens]], [[Dinah Washington]], [[Ellen Wilkinson]], and [[Alan Wilson (musician)|Alan Wilson]]; in some cases these have been speculated to be suicides as well. Those who died of a combination of barbiturates and other drugs include [[Rainer Werner Fassbinder]], [[Dorothy Kilgallen]], [[Malcolm Lowry]], [[Edie Sedgwick]] and [[Kenneth Williams]]. [[Dorothy Dandridge]] died of either an overdose or an unrelated [[embolism]]. [[Ingeborg Bachmann]] may have died of the consequences of barbiturate withdrawal (she was hospitalized with burns, the doctors treating her not being aware of her barbiturate addiction).