What are the main clinical manifestations of barbiturate poisoning?
Nov 25, 2025
Source: Cainiu Health
Dr. Wang Lei
Introduction
In general, barbiturate poisoning is characterized by central nervous system depression, with clinical manifestations primarily including central nervous system suppression, respiratory depression, circulatory abnormalities, gastrointestinal symptoms, and changes in skin and mucous membranes. Barbiturates must be used strictly according to medical instructions, avoiding overdose or concomitant use with alcohol or sedatives.
Under normal circumstances, barbiturate poisoning primarily involves central nervous system depression, with clinical manifestations including central nervous system suppression, respiratory depression, circulatory abnormalities, gastrointestinal symptoms, and changes in skin and mucous membranes. A detailed analysis is as follows:
1. Central nervous system depression: Mild poisoning presents with drowsiness, dizziness, fatigue, slurred speech, and impaired judgment; moderate poisoning manifests as somnolence, with brief responses to calling and diminished tendon reflexes; severe poisoning leads to coma, unresponsiveness to painful stimuli, absent tendon reflexes, and may be accompanied by seizures or muscle rigidity in some patients.
2. Respiratory depression: The drug suppresses the respiratory center, causing abnormal breathing. In mild poisoning, respiratory rate is slightly slowed; in moderate to severe cases, breathing becomes shallow and slow with irregular rhythm, and in serious cases, Cheyne-Stokes respiration or apnea may occur.
3. Circulatory abnormalities: Early circulation remains stable, but in severe poisoning, vasodilation and weakened myocardial contractility lead to hypotension and tachycardia. In critical cases, shock may develop, characterized by pallor, cold and clammy extremities, and weak pulse.
4. Gastrointestinal symptoms: Patients who ingest the drug orally often experience nausea, vomiting, abdominal pain, and diarrhea early on, with vomitus possibly having a distinctive odor of the drug. Long-term or severe poisoning can impair liver function, leading to jaundice and hepatic discomfort; laboratory tests may show elevated transaminase levels.
5. Skin and mucous membrane changes: Some patients may develop allergic reactions such as itching, erythema, or urticaria; those with severe poisoning may have cold, clammy skin and cyanosis. Due to circulatory impairment or drug irritation, ecchymoses or blisters may appear, commonly seen in pressure areas.
Barbiturates must be used strictly according to medical instructions, avoiding overdose or co-administration with alcohol or sedatives. Medications should be properly stored in daily life to prevent accidental ingestion. Once signs of suspected poisoning are detected, unabsorbed drugs should be promptly removed, airway patency maintained, and emergency treatment initiated immediately.
