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AHFS/Drugs.com | Micromedex Detailed Consumer Information |
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Routes of administration | Oral, IM, IV, Rectal |
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Metabolism | Hepatic |
Elimination half-life | 8–42 hours |
Excretion | Renal |
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ECHA InfoCard | 100.000.300 |
Chemical and physical data | |
Formula | C11H18N2O3 |
Molar mass | 226.276 g·mol−1 |
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Amobarbital (formerly known as amylobarbitone or sodium amytal as the soluble sodium salt) is a drug that is a barbiturate derivative. It has sedative-hypnotic properties. It is a white crystalline powder with no odor and a slightly bitter taste. It was first synthesized in Germany in 1923. It is considered a short to intermediate acting barbiturate.[ citation needed ]
If amobarbital is taken for extended periods of time, physiological and psychological dependence can develop. Amobarbital withdrawal mimics delirium tremens and may be life-threatening. Amobarbital was manufactured by Eli Lilly and Company in the US under the brand name Amytal in bright blue bullet shaped capsules (known as Pulvules) or pink tablets (known as Diskets) [2] containing 50, 100, or 200 milligrams of the drug. The drug was also manufactured generically.
Amobarbital was widely misused, known as "Blue Heavens" on the street. Amytal, as well as Tuinal, a combination drug containing equal quantities of secobarbital and amobarbital, were both manufactured by Eli Lilly until the late 1990s. However, as the popularity of benzodiazepines increased, prescriptions for these medications became increasingly rare beginning in the mid to late 1980s.
In an in vitro study in rat thalamic slices, amobarbital worked by activating GABAA receptors, which decreased input resistance, depressed burst and tonic firing, especially in ventrobasal and intralaminar neurons, while at the same time increasing burst duration and mean conductance at individual chloride channels; this increased both the amplitude and decay time of inhibitory postsynaptic currents. [3]
Amobarbital has been used in a study to inhibit mitochondrial electron transport in the rat heart in an attempt to preserve mitochondrial function following reperfusion. [4]
A 1988 study found that amobarbital increases benzodiazepine receptor binding in vivo with less potency than secobarbital and pentobarbital (in descending order), but greater than phenobarbital and barbital (in descending order). [5] (Secobarbital > pentobarbital > amobarbital > phenobarbital > barbital)
It has an LD50 in mice of 212 mg/kg s.c. [ citation needed ]
Amobarbital undergoes both hydroxylation to form 3'-hydroxyamobarbital, [6] and N-glucosidation [7] to form 1-(beta-D-glucopyranosyl)-amobarbital. [8]
When given slowly by an intravenous route, sodium amobarbital has a reputation for acting as a so-called truth serum. Under the influence, a person will divulge information that under normal circumstances they would block. This was most likely due to loss of inhibition. As such, the drug was first employed clinically by William Bleckwenn at the University of Wisconsin to circumvent inhibitions in psychiatric patients. [9] The use of amobarbital as a truth serum has lost credibility due to the discovery that a subject can be coerced into having a "false memory" of the event. [10]
The drug may be used intravenously to interview patients with catatonic mutism, sometimes combined with caffeine to prevent sleep. [11]
It was used by the United States armed forces during World War II in an attempt to treat shell shock and return soldiers to the front-line duties. [12] This use has since been discontinued as the powerful sedation, cognitive impairment, and dis-coordination induced by the drug greatly reduced soldiers' usefulness in the field. Amobarbital was once manufactured in the US by Eli Lilly Pharmaceuticals under the brand name Amytal in capsule form. It was discontinued in the early 1980s, largely replaced by the benzodiazepine family of drugs. Amobarbital was also widely abused, known on the streets as "blue heavens" because of their blue capsule.
The following drugs should be avoided when taking amobarbital:
Amobarbital has been known to decrease the effects of hormonal birth control. [13]
Some side effects of overdose include confusion (severe); decrease in or loss of reflexes; drowsiness (severe); fever; irritability (continuing); low body temperature; poor judgment; shortness of breath or slow or troubled breathing; slow heartbeat; slurred speech; staggering; trouble in sleeping; unusual movements of the eyes; weakness (severe). Severe overdose may result in death without intervention.
Amobarbital (5-ethyl-5-isoamylbarbituric acid), like all barbiturates, is synthesized by reacting malonic acid derivatives with urea derivatives. In particular, in order to make amobarbital, α-ethyl-α-isoamylmalonic ester is reacted with urea (in the presence of sodium ethoxide). [14] [15]
The drug has been used to gain confessions from murderers such as Andres English-Howard, who strangled his girlfriend to death but claimed innocence. He was surreptitiously administered the drug by his lawyer, and under the influence of it he revealed why he strangled her and under what circumstances. [16]
On the night of August 28, 1951, the housekeeper of actor Robert Walker found him to be in an emotional state. She called Walker's psychiatrist who arrived and administered amobarbital for sedation. Walker was allegedly drinking prior to his emotional outburst, and it is believed the combination of amobarbital and alcohol resulted in a severe reaction. As a result, he passed out and stopped breathing, and all efforts to resuscitate him failed. Walker died at 32 years old.
The British actor and comedian Tony Hancock killed himself in Australia in 1968 using the drug in combination with alcohol.
Eli Lilly manufactured amobarbital under the brand name Amytal until it was discontinued in the 1980s and replaced largely by the benzodiazepine family of drugs. Amytal was also widely abused. Street names for amobarbital include "blues", "blue angels", "blue birds", "blue devils", and "blue heavens" due to their blue capsule. [17]
In Len Deighton's 1967 novel An Expensive Place to Die , a combination of amytal and LSD is used to make the unnamed protagonist respond to questioning about his activities.
In Thomas Pynchon's 1973 novel Gravity's Rainbow , sodium amytal is used by a military intelligence unit as some kind of truth serum to extract Tyrone Slothrop's (the novel's protagonist) ideas on racism of white Americans against Afro-Americans during the 1930s in his home state of Massachusetts (Chapter 1).
In the 1975 Columbo episode "A Deadly State of Mind" the victim Nadia Donner has Amobarbital found in her blood according to the autopsy report. [18] [19] [20]
In the 1994 comedic action thriller True Lies , the protagonist Harry Tasker (portrayed by Arnold Schwarzenegger) is given sodium amytal as a truth serum, when questioned by terrorists.
In 2001, the Law & Order: Special Victims Unit episode "Repression" (Season 3, Episode 1), a therapist (Shirley Knight) treats her patient with "sodium amytal". The character Dr. George Huang (BD Wong) claims that the drug leaves a patient so susceptible to suggestion, that the therapist is able to implant false memories in the patient.
In 2003, the animated series Sealab 2021 season 3, episode 7, "Tourist Season", Dr. Quentin Q. Quinn, voiced by Brett Butler, uses "sodium amytal" to induce amnesia in a group of tourists, in order to prevent them from taking action against Sealab as a result of a hare-brained scheme by Capt. Murphy. He gives the dose in a free alcoholic beverage as a parting gift before the tourists leave, and in quantities he describes that could "make an elephant forget".
In the 2005 movie, Hellraiser: Hellworld , the main antagonist uses "sodium amytal" to secretly anesthetize the people he believes were responsible for his son's death, and induce extreme hallucinations in them.
In 2016, television drama A Fist Within Four Walls episode 14, Man Zeun (portrayed by Princeton Lock) uses sodium amytal in an attempt to force gambling addict Lee Fat into paying debts.
In 2022, in "Diophantine Pseudonym", Episode 06 of Dan Brown's The Lost Symbol , sodium amytal is used by the CIA as a truth serum.
Ben Kimmelman, Captain, 28th Infantry: The assumptions were that this would have some kind of cathartic effect, the sodium amytal, which the men called blue 88's. You know, the most effective artillery piece of the Germans was the 88 and this was blue 88s, because the sodium amytal was a blue tablet.
Hypnotic, or soporific drugs, commonly known as sleeping pills, are a class of psychoactive drugs whose primary function is to induce sleep and to treat insomnia (sleeplessness).
Sodium thiopental, also known as Sodium Pentothal, thiopental, thiopentone, or Trapanal, is a rapid-onset short-acting barbiturate general anesthetic. It is the thiobarbiturate analog of pentobarbital, and an analog of thiobarbital. Sodium thiopental was a core medicine in the World Health Organization's List of Essential Medicines, but was supplanted by propofol. Despite this, thiopental is listed as an acceptable alternative to propofol, depending on local availability and cost of these agents. It was the first of three drugs administered during most lethal injections in the United States until the US division of Hospira objected and stopped manufacturing the drug in 2011, and the European Union banned the export of the drug for this purpose. Although thiopental abuse carries a dependency risk, its recreational use is rare.
"Truth serum" is a colloquial name for any of a range of psychoactive drugs used in an effort to obtain information from subjects who are unable or unwilling to provide it otherwise. These include ethanol, scopolamine, 3-quinuclidinyl benzilate, midazolam, flunitrazepam, sodium thiopental, and amobarbital, among others.
A sedative or tranquilliser is a substance that induces sedation by reducing irritability or excitement. They are CNS depressants and interact with brain activity causing its deceleration. Various kinds of sedatives can be distinguished, but the majority of them affect the neurotransmitter gamma-aminobutyric acid (GABA). In spite of the fact that each sedative acts in its own way, most produce relaxing effects by increasing GABA activity.
Tuinal was the brand name of a discontinued combination drug composed of two barbiturate salts in equal proportions.
Clonazepam, sold under the brand name Klonopin among others, is a medication used to prevent and treat anxiety disorders, seizures, bipolar mania, agitation associated with psychosis, obsessive–compulsive disorder, and akathisia. It is a long-acting tranquilizer of the benzodiazepine class. It possesses anxiolytic, anticonvulsant, sedative, hypnotic, and skeletal muscle relaxant properties. It is typically taken orally but is also used intravenously. Effects begin within one hour and last between eight and twelve hours in adults.
Phenobarbital, also known as phenobarbitone or phenobarb, sold under the brand name Luminal among others, is a medication of the barbiturate type. It is recommended by the World Health Organization (WHO) for the treatment of certain types of epilepsy in developing countries. In the developed world, it is commonly used to treat seizures in young children, while other medications are generally used in older children and adults. It is also used for veterinary purposes. It may be administered by slow intravenous infusion, intramuscularly (IM), or orally. Subcutaneous administration is not recommended. The IV or IM may be used to treat status epilepticus if other drugs fail to achieve satisfactory results. Phenobarbital is occasionally used to treat insomnia, anxiety, and benzodiazepine withdrawal, and prior to surgery as an anxiolytic and to induce sedation. It usually begins working within five minutes when used intravenously and half an hour when administered orally. Its effects last for between four hours and two days.
Secobarbital is a short-acting barbiturate derivative drug that was patented in 1934 in the United States. It possesses anaesthetic, anticonvulsant, anxiolytic, sedative, and hypnotic properties. In the United Kingdom, it was known as quinalbarbitone. Secobarbital is considered to be an obsolete sedative-hypnotic, and as a result, it has largely been replaced by the benzodiazepine family. Seconal was widely abused, known on the street as "red devils" or "reds". Among the barbiturates, secobarbital carries a particularly high risk of abuse and addiction, largely responsible for its falling out of use.
Pentobarbital (US) or pentobarbitone is a short-acting barbiturate typically used as a sedative, a preanesthetic, and to control convulsions in emergencies. It can also be used for short-term treatment of insomnia but has been largely replaced by the benzodiazepine family of drugs.
Butabarbital is a prescription barbiturate sleep aid and anxiety medication. Butabarbital has a particularly fast onset of effects and short duration of action compared to other barbiturates, which makes it useful for certain applications such as treating severe insomnia, relieving general anxiety and relieving anxiety before surgical procedures; however it is also relatively dangerous particularly when combined with alcohol, and so is now rarely used, although it is still prescribed in some Eastern European and South American countries. Its intermediate duration of action gives butabarbital an abuse potential slightly lower than secobarbital. Butabarbital can be hydrolyzed to valnoctamide.
Narcosynthesis is a technique of treating post-traumatic stress disorder popularized by psychiatrists in the post-World War II era. Also called sodium amytal interview, amobarbital interview, or amytal interview, it uses free association as well as dream and transference material during the session as a basis for uncovering relevant topics for later therapeutic discussion.
Mebutamate is an anxiolytic and sedative drug with antihypertensive effects of the carbamate class. It has effects comparable to those of barbiturates such as secobarbital, but is only around 1/3 the potency of secobarbital as a sedative. Side effects include dizziness and headaches.
Desbutal was a brand name drug by Abbott containing 5 mg methamphetamine hydrochloride (Desoxyn) and 30 mg pentobarbital sodium (Nembutal); a substituted amphetamine and a barbiturate combined within the same pill. Desbutal was marketed as an antidepressant as well as a medication for the treatment of obesity, narcolepsy, parkinsonism, and alcoholism, although it was commonly also prescribed off-label for miscellaneous ailments. It had a high abuse potential and is no longer manufactured.
Barbiturates are a class of depressant drugs that are chemically derived from barbituric acid. They are effective when used medically as anxiolytics, hypnotics, and anticonvulsants, but have physical and psychological addiction potential as well as overdose potential among other possible adverse effects. They have been used recreationally for their anti-anxiety and sedative effects, and are thus controlled in most countries due to the risks associated with such use.
William Jefferson Bleckwenn was an American neurologist, psychiatrist, and military physician, who was instrumental in developing the treatment known as "narcoanalysis" or "narcosynthesis", also known by the lay term "truth serum".
Barbiturate dependence develops with regular use of barbiturates. This in turn may lead to a need for increasing doses of the drug to get the original desired pharmacological or therapeutic effect. Barbiturate use can lead to both addiction and physical dependence, and as such they have a high potential for excess or non-medical use, however, it does not affect all users. Management of barbiturate dependence involves considering the affected person's age, comorbidity and the pharmacological pathways of barbiturates.
The Dille–Koppanyi reagent is used as a simple spot-test to presumptively identify barbiturates. It is composed of a mixture of two solutions. Part A is 0.1 g of cobalt(II) acetate dihydrate dissolved in 100 ml of methanol mixed with 0.2 ml of glacial acetic acid. Part B made up of is 5% isopropylamine (v/v) in methanol. Two drops of A are dropped onto the substance followed by one drop of B and any change in colour is observed.
In pharmacology, GABAA receptor positive allosteric modulators, also known as GABAkines or GABAA receptor potentiators, are positive allosteric modulator (PAM) molecules that increase the activity of the GABAA receptor protein in the vertebrate central nervous system.
A euthanasia solution is a drug-containing aqueous solution for intentionally ending life to either relieve pain and suffering or execute convicts. The drugs used in euthanasia solution do not only need to be safe to personnel, but they also need to have a rapid onset of action and minimize the possible pain felt by humans and animals. To satisfy these requirements, the active ingredients in the euthanasia solution are usually anaesthetics, respiratory depressants, cardiotoxic drugs and cytotoxic drugs.
Tedral, or theophylline/ephedrine/phenobarbital, is a medicine formerly used to treat respiratory diseases such as asthma, chronic obstructive lung disease (COPD), chronic bronchitis, and emphysema. It is a combination drug containing three active ingredients - theophylline, ephedrine, phenobarbital. This medication relaxes the smooth muscle of the airways, making breathing easier. The common side effects of Tedral include gastrointestinal disturbances, dizziness, headache and lightheadedness. However, at high dose, it may lead to cardiac arrhythmias, hypertension, seizures or other serious cardiovascular and/or central nervous system adverse effects. Tedral is contraindicated in individuals with hypersensitivity to theophylline, ephedrine and/or phenobarbital. It should be also used in caution in patients with cardiovascular complications, such as ischemic heart disease and heart failure and/or other disease conditions. It can cause a lot of drug–drug interactions. Therefore, before prescribing patient with Tedral, drug interactions profile should be carefully checked if the patient had other concurrent medication(s). Being used as a treatment option for respiratory diseases for decades, Tedral was withdrawn from the US market in 2006 due to safety concerns.