Bartiburate coma/neuron activity

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  1. Mechanism of action
    1. same as for alcohol – suppressed neuronal transmission, presumably by enhancing GABA inhibition at pre- and postsynaptic receptors and reduction of excitatory postsynaptic potentials.
      1. By doing this, cerebral metabolism is suppressed and thus cerebral blood flow is decreased which will decrease intracranial pressure (ICP)
      2. Commonly causes hypotension
      3. Dosage: pentobarbital 10 mg/kg then three doses of 5 mg/kg at 1-hour intervals then 1-2 mg/kg/hr
    2. EEG findings: at low doses, normal activity is replaced by fast activity of 20-30 Hz; at increasing levels, fast waves become less regular and interspersed with 3-4 Hz slow activity; at higher doses there are short periods of suppression of all activity separated by bursts of slow (delta) waves; at very high levels electrical activity ceases
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