phenobarbital for DT's

[Opiyum]

I have about a billion pheno pills from way back that i never decided to eat cause i never enjoyed the effect and Im wondering If they can be given to a friend of mine who needs to sober up but needs to avoid dieing from the DT's. Im just wondering if it can be used to get a perosn through DT's if done properly as far as dosing goes.
Ive heard of methadone and other opiates plus librium but not pheno. I am assuming from the little research i have done so far that it can be done.
Any advice or opinions on the subject from those with medical know how or experience with this type of situation would be much appreciated. One of the reasons Im asking to begin with is due to the fact that this perosn does not want to go to a hospital for quite a few reason.

Im not so sure this is something I want to do considering the risk but if its not as dangerous as I think than maybe it is worth a go. I figure if shit went down a hospital isnt far from my house. My Xgirlfriends father was a fifth for breakfast 2 for lunch and 2 for dinner kinda guy (little exaggeration if any) and had been working his way up to that point for few decades and I got first hand experience there when it comes to DT's. It was only in its early stages while i drove him to the hospital but by the time he got there and right before they dosed him it definately didnt seem like something I would ever want to deal with. Nor would i ever want to take care of someone going thru that but im thinking the pheno would basically knock my buddy out during the worst part of it.

THanks in advance.

[nick]

I'm an ex alcoholic and the hardest part of stopping(like virtually all wds) is the psychological aspect.

You can give this guy all the tranqs or junk in the world,but he's really got to want to stop and have be given a whole lot of support.

Good luck with it bro-you have your work cut out for you on this one.

[Beautifully_Broken]

i was given phenobarb my first night of my first trip to rehab, because i had not been given any detox meds yet so was getting aggitated and couldnt sleep, and the BITCH of a dosing nurse said "i cant give u anything for sleep, your used to self medicating to sleep and we have to break that habiat" w/ this smug smile. so after throwing things at her window didnt work (damn unbreakable material :mad:) i pulled my blanket in front of the charge nurse's desk and proceeded to shake violently. after about 20 mins she ordered the nurse to give me somthing:D i gotta say, i dont remember much of a buzz, but it was pretty relaxing, and i did sleep

[roxi*stardust]

I asked the mods to possibly move this to a forum where a health professional is available. DT's are EXTREMELY dangerous. A hospital ICU is the best place for your friend to be. I understand there are reasons he may not want to go but he should be aware of the risks. Here is some info I found for you, this is not all inclusive but it does shed light on your question. Please be careful.

MEDICATION Section 7 of 10

A large number of pharmacologic agents have been used to treat DT; however, benzodiazepines are the medication of choice because they have a high therapeutic index and interact with ethanol on the benzodiazepine-GABAa-chloride receptor complex. Benzodiazepines such as diazepam have an ideal pharmacologic profile because of their rapid onset of action and prolonged duration of effects. Benzodiazepine dose required may be highly variable and should be titrated until the patient is calm and peaceful. For some patients, several hundred milligrams of a diazepam equivalent may be required over the first few hours.
Barbiturates such as phenobarbital and pentobarbital also are useful to treat DT despite their lower therapeutic indexes. Barbiturates may be required (rarely) for patients refractory to benzodiazepine treatment.
Do not use phenothiazines, because they lower the seizure threshold and do not affect the benzodiazepine-GABAa-chloride receptor complex.
Ethanol is effective in blunting withdrawal symptoms, but it is no longer indicated because of associated electrolyte abnormalities, potential worsening of gastritis, hepatitis, and pancreatitis. Ethanol use may promote continued ethanol usage.
Phenytoin is probably not helpful in most patients with DT and seizures. Benzodiazepines or barbiturates treat seizures and manifestations of DT.

Drug Category: Benzodiazepines -- These agents bind to benzodiazepine receptors in the benzodiazepine-GABAa-chloride receptor complex to enhance the binding of GABA, causing enhanced chloride flux, hyperpolarization of the membrane, and neural inhibitory effects. Drug Name
Diazepam (Valium) -- Because of rapid onset, prolonged duration of effects, and high therapeutic index, diazepam is drug of choice. Volumes of literature exist regarding usage of diazepam for ethanol withdrawal. Onset of action is within a couple of min after IV administration. Has active metabolite (desmethyl-diazepam) that has longer duration of action than diazepam. Adult Dose5-10 mg IV bolus q5-15min until sedated
Large cumulative doses may be required to treat DT Pediatric Dose0.05-0.3 mg/kg/dose IV over 2-3 min q15-30min until sedated; not to exceed 5 mg/dose ContraindicationsDocumented hypersensitivity; narrow-angle glaucoma Interactions Increases toxicity of benzodiazepines in CNS with coadministration of phenothiazines, barbiturates, alcohols, or MAOIs PregnancyD - Unsafe in pregnancy PrecautionsCaution with other CNS depressants, low albumin levels, or hepatic disease (may increase toxicity)Drug Name
Lorazepam (Ativan) -- Sedative hypnotic in benzodiazepine class that has short onset of effect and relatively long half-life. Monitor patient's BP after administering dose and adjust as necessary. Adult Dose1-2 mg IV bolus q5-15min until sedated Pediatric Dose0.1 mg/kg IV slowly over 2-5 min; repeat prn in 10-15 min at a dose of 0.05 mg/kg IV administered slowly until sedated; not to exceed 4 mg/dose ContraindicationsDocumented hypersensitivity; preexisting CNS depression; hypotension; narrow-angle glaucoma InteractionsToxicity of benzodiazepines in CNS increases when used concurrently with alcohol, phenothiazines, barbiturates, or MAOIs PregnancyD - Unsafe in pregnancy PrecautionsBecause of delayed peak onset of action, sedation may not peak for 20-30 min; cumulative effects of repeated bolus may cause sudden onset of oversedation or respiratory depression
Caution in renal or hepatic impairment, myasthenia gravis, organic brain syndrome, or Parkinson diseaseDrug Name
Chlordiazepoxide (Librium) -- Depresses all levels of CNS including limbic and reticular formation, possibly by increasing GABA activity. Parenteral form usually used initially. Adult Dose50-100 mg IV q5-15min until sedated Pediatric DoseNot established ContraindicationsDocumented hypersensitivity; narrow-angle glaucoma InteractionsCoadministration with alcohols, phenothiazines, barbiturates, or MAOIs increases CNS toxicity; cisapride can increase levels significantly PregnancyD - Unsafe in pregnancy PrecautionsCumulative effects of repeated bolus may cause sudden onset of oversedation or respiratory depression
Caution in low albumin levels or hepatic failure, as diazepam toxicity may increaseDrug Category: Barbiturates -- These agents have direct effects on benzodiazepine-GABAa-chloride receptor complex in enhancing chloride flux. Barbiturates may be useful in patients refractory to benzodiazepines. Respiratory depression may be common at large doses. Ventilatory support may be required in most patients receiving high-dose barbiturates. Because of their lower therapeutic index, benzodiazepines should be considered the DOC. Drug Name
Phenobarbital (Luminal, Barbita) -- Have direct effects on benzodiazepine-GABAa-chloride receptor complex in enhancing chloride flux. May be useful in patients refractory to benzodiazepines. Exhibits anticonvulsant properties in anesthetic doses. Since a barbiturate-induced depression may occur, especially after previous benzodiazepine therapy, early mechanical ventilation should be considered. Adult Dose130 mg IV over 1-2 min q5-15min until sedated Pediatric DoseNot established ContraindicationsDocumented hypersensitivity; severe respiratory disease; marked impairment of liver function; nephritis InteractionsCoadministration with alcohol may produce additive CNS effects and death; may decrease effects of chloramphenicol, digitoxin, corticosteroids, carbamazepine, theophylline, verapamil, metronidazole, and anticoagulants (patients stabilized on anticoagulants may require dosage adjustments if added to or withdrawn from their regimen); chloramphenicol, valproic acid, and MAOIs may increase toxicity; rifampin may decrease effects; induction of microsomal enzymes may result in decreased effects of oral contraceptives in women (must use additional contraceptive methods to prevent unwanted pregnancy; menstrual irregularities may also occur) PregnancyD - Unsafe in pregnancy PrecautionsIn prolonged therapy, evaluate hematopoietic, renal, hepatic, and other organ systems; caution in fever, hyperthyroidism, diabetes mellitus, and severe anemia since adverse reactions can occur; caution in myasthenia gravis and myxedemaDrug Name
Pentobarbital (Nembutal) -- Short-acting barbiturate with sedative, hypnotic, and anticonvulsant properties and can produce all levels of CNS mood alteration. Adult Dose100 mg IV over 1-2 min q5-15min until sedated Pediatric DoseNot established ContraindicationsDocumented hypersensitivity; liver failure InteractionsConcomitant use with alcohol may produce additive CNS effects and death; chloramphenicol may inhibit metabolism; may enhance chloramphenicol metabolism; MAOIs may enhance sedative effects; valproic acid appears to decrease metabolism, increasing toxicity; can decrease effects of anticoagulants (patients may require dosage adjustments if barbiturates added to or withdrawn from regimen); may decrease oral contraceptive effect by induction of microsomal enzymes (alternate form of birth control suggested); may decrease corticosteroid and digitoxin effects through induction of hepatic microsomal enzymes, which increase metabolism; decreases theophylline levels, and may decrease effects; may decrease verapamil bioavailability PregnancyD - Unsafe in pregnancy PrecautionsPatient may become tolerant to hypnotic effects; caution in hypovolemic shock, respiratory dysfunction, renal dysfunction, previous addiction to sedative hypnotics, and CHFDrug Category: Vitamins and Nutrients -- These agents are used to treat the hypoglycemia and nutrient deficiencies associated with DT.
Alcoholics usually are deficient in thiamine, which functions as a cofactor for a number of important enzymes, such as pyruvate dehydrogenase, transketolase, and alpha-ketoglutarate dehydrogenase. Deficiency leads to Wernicke encephalopathy, peripheral neuropathy, cardiomyopathy, and metabolic acidosis.
Alcoholics usually are magnesium deficient due to a poor nutritional status and malabsorption from ethanol. Magnesium stabilizes membranes, helps in the maintenance of potassium and calcium homeostasis, and may protect against seizures and arrhythmias. Drug Name
Dextrose 50% (D-Glucose) -- Monosaccharide absorbed from intestine and distributed, stored, and used by tissues. Parenterally injected dextrose used in patients unable to obtain adequate oral intake. Direct oral absorption results in rapid increase of blood glucose concentrations. Effective in small doses; no evidence of toxicity. Concentrated dextrose infusions provide higher amounts of glucose and increased caloric intake, with minimal fluid volume. Use 1 ampule of 50 mL of a 50% glucose solution (25 g). Adult Dose0.5-1 mg/kg IV bolus Pediatric Dose<12 years: Not established
>12 years: Administer as in adults ContraindicationsDo not administer to a patient in diabetic coma if blood sugar levels are extremely high, and avoid in severely dehydrated patients
Do not administer concentrated solution if intraspinal or intracranial hemorrhage is present; avoid in dehydrated patients with DT, hepatic coma, or glucose-galactose malabsorption syndrome InteractionsCaution when administering parenteral fluids to patients receiving corticosteroids or corticotropin, especially if solution contains sodium ions PregnancyA - Safe in pregnancy PrecautionsExtravasation may cause significant tissue necrosis when used IV; Isolated reports of nausea, which may also occur with hypoglycemia, have been recorded; Dextrose solutions administered IV can result in dilution of serum electrolyte concentrations and overhydration when there is fluid overload; caution in congested states or pulmonary edemaDrug Name
Thiamine (Vitamin B-1) -- Used to treat thiamine deficiency, including Wernicke encephalopathy syndrome. Adult Dose100 mg IV Pediatric Dose50 mg IV initially, followed by 10-25 mg/d IV/IM ContraindicationsDocumented hypersensitivity InteractionsNone reported PregnancyA - Safe in pregnancy PrecautionsSensitivity reactions can occur (intradermal test-dose recommended in suspected sensitivity); deaths have resulted from IV use; sudden onset or worsening of Wernicke encephalopathy, following glucose, may occur in thiamine-deficient patients; administer before or together with dextrose-containing fluids in suspected thiamine deficiencyDrug Name
Folic acid (Folate) -- Dietary deficiency of folic acid common in alcoholics. Folic acid important cofactor for enzymes used in production of RBCs. Adult Dose1 mg PO/IV Pediatric DoseAdminister as in adults ContraindicationsDocumented hypersensitivity InteractionsIncrease in seizure frequency and decrease in subtherapeutic levels of phenytoin reported when used concurrently PregnancyA - Safe in pregnancy PrecautionsBenzyl alcohol may be contained in some products as a preservative (associated with a fatal gasping syndrome in premature infants); resistance to treatment may occur in patients with alcoholism and deficiencies of other vitaminsDrug Name
Magnesium sulfate -- Used to treat and prevent seizures. Decreases amount of acetylcholine liberated at endplate by motor nerve impulse. Blocks neuromuscular transmission associated with seizure activity. Magnesium also has CNS depressant effect. Monitor carefully; may cause respiratory depression, hyporeflexia, and bradycardia. Infusion should be discontinued if reflexes are absent or if magnesium levels exceed 6-8 mEq/L. Calcium chloride, 10 mL IV of a 10% solution, can be given as antidote for clinically significant hypermagnesemia. Adult Dose2 g in 50 mL of D5W over 20 min IV Pediatric Dose25-50 mg/kg/dose; maximum single dose of 2 g may also be administered and repeated if hypomagnesemia persists ContraindicationsDocumented hypersensitivity; heart block; Addison disease; myocardial damage; severe hepatitis InteractionsConcurrent use with nifedipine may cause hypotension and neuromuscular blockade; may increase neuromuscular blockade seen with aminoglycosides and potentiate neuromuscular blockade produced by tubocurarine, vecuronium, or succinylcholine; may increase CNS effects and toxicity of CNS depressants or betamethasone; may increase cardiotoxicity of ritodrine PregnancyA - Safe in pregnancy PrecautionsMagnesium may alter cardiac conduction, leading to heart block in digitalized patients; respiratory rate, deep tendon reflexes, and renal function should be monitored when electrolyte is administered parenterally; caution when administering, since may produce significant hypertension or asystole; in overdose, calcium gluconate, 10-20 mL IV of 10% solution, can be given as antidote for clinically significant hypermagnesemia FOLLOW-UP Section 8 of 10

Further Inpatient Care:

Admit all patients with DT to the ICU.
Continue sedation as necessary to keep to patients calm. Sedation dosing may be tapered over the next 5-7 days. Due to the long duration of action of diazepam or phenobarbital, patients who are adequately sedated initially may require prolonged monitoring and treatment.
complete page
http://www.emedicine.com/EMERG/topic123.htm

[HistoryofMadness]

so this is alcohol? do you really want the liability and guilt of a mistake while trying to give this guy medical treatment you learned on the internet?

all i know is barbs have horrific WD symptoms too, and that's all you need is to be tagged for supplying this guy...

i guess you can tell i'm thinking this is a bad idea. he needs to go to the hospital if he's that bad off. alcoholics are not out of the woods for a week or more AFTER they're totally clean, and that's AFTER they've tapered...

no way man.

[roxi*stardust]

so this is alcohol? do you really want the liability and guilt of a mistake while trying to give this guy medical treatment you learned on the internet?

all i know is barbs have horrific WD symptoms too, and that's all you need is to be tagged for supplying this guy...

i guess you can tell i'm thinking this is a bad idea. he needs to go to the hospital if he's that bad off. alcoholics are not out of the woods for a week or more AFTER they're totally clean, and that's AFTER they've tapered...

no way man.
AGREE 150% with this. DT's are very very dangerous and you can see from the quote I used above, doasge and tapering should be calculated by blood work, something you can not provide. It also says effective dosages of phenobarb for DT cause severe respitory deppression, enough so that mechanical ventilation is often necessary. I would not take any chances, please try to convince him that the ICU unit is the best place to be for his health and safety and your piece of mind.

[jacky]

I just had a freind die from alchohol withdrawl. he was 35, married to a girl who was recently diagnosed with cancer.
he decided to quit cold turkey so he could better help her with her illness.

I dont think he researched, or got an opinion from any health care proff. on how to go about quitting.

he died in his sleep, from alchohol withdrawl complications.

he drank beer, about a 12 pack a night. thats it, beer.

so I would be careful dealing with alchohol withdrawl. similiarly to heroin withdrawl if you have a bad heart.

what kills me is this guy was just trying to help his girl, and now she is all alone.

R.I.P Andy "capps"
he was the first drummer for Built To Spill.
he was building a trench in his backyard, a copy of world war 1 trench warfare designs, I think his reason was mostly historical, and to show kids how much has changed, and hasnt.
he was a small, skinny, quiet, humble person, and I can think of a hundred other loudmouths that should have gone before him.

[nick]

Jacky, so sorry for the loss of your pal.I've lost a lot of friends and it NEVER gets any easier.

The point I'm making about this detox is even if it works(which I wouldn't take bets on) what are you going to do with this guy afterwards?
You can get booze out of your body-getting it out of your mind ain't so easy.

As I said before Much much good luck.

[Diacetyl]

Man, fuck barbs in general. The high isn't that great and the possibility of ODing is extremely high. I do belive barbs build up in your liver making OD an unfortunate reality with regular use.

[candy]

Valium is the drug of choice for your friend and he should be in a hospital setting where he can be monitored. I would just encourage the best you can to go into the hospital and get treatment.

And where did you get these phenobarbital and how old are they? I wouldn't want the responsibility of giving any friend of mine any drug I wasn't sure of. Doses can vary depending on how bad they react to detoxing. Fooling around with dosages could just lead to more problems.

DT's can be dangerous and life threatening and despite what his issues are on not wanting to go to a rehab facility or hospital. Let him know that you are not capable of taking care of him.
This is serious business!

[Dolophine]

As for the Pheno, yah it could probably help ease the delirium tremens or whatever it's called (DT's) and it would probably ease your friends suffering alot, but there is always the question of dosage and him not really knowing how he feels or how much is too much and you aren't him so you can't really gauge how much he needs. He might think he needs more than he needs and OD on you and then you will have to deal with it. Be EXTREMELY careful. I don't see why he won't go to a hospital there is no shame in being an alcoholic, it happens to the best of us. It's not frowned upon as much as being a junkie or crackhead or something so I don't see why he doesn't just do a detox in a hospital. I wouldn't want to be responsible for any problems, cuz DT"s are super dangerous and people die from that shit and he's going to be in rough shape. He needs to be watched by nurses and stuff incase shit goes wrong and he needs certain medications. I wouldnt fuck around with that, but it's your choice. Use extreme caution when giving people drugs. When I was young I gave my friend 200mg of Methadone and he was opiate intolerant as in NEVER TRIED Morphine, or CODEINE or anything recreationally. And he almost died. He was deathly ill for 3 days and I never called the ambulance i watched him and stayed up with him making sure he didnt stop breathing. Man i'm so lucky he didnt die. What was I thinking giving him 200mg of Methadone at that age with no tolerance. I could take 200mg at that time but we were like 16 and he almost croaked on me. He was totally blue and just sick as a dog. Through the whole thing he was smoking weed like a maniac though, i think thats what got him through it. The weed seemed to alleviate the sickness. He was on a major nod but every hour he'd wsake up and smoke a joint and i dont even know how he did cuz he wasnt even on this planet he was so out of it he was like blue and grey and half dead. I had to roll the joints but the guy smoked like a champion even with the "Done" threatening his very existance. The guy couldn't even stand. I had to carry him to the car to bring him home and he said to his dad he had food poisoning which was a major lie and how the fuck could anyone look at him and think he had food poisoning he looked so sick, beyond sick i've never seen anyone as sick as him unless they were dying. I'm so happy he made it out of that. For both our sake.

I drank from age 13 to 19 and the most I ever drank in the span of 4 hours was a 60 ouncer of gin with lemonade concentrate added to each glass to soften the blow lmao. My friends were sitting there in awe wondering how I could do it because they were heavy drinkers too and they were drinking the same brand of gin as I was just in 26 ounce bottles and they only got through a "mickeys" worth which is 12 ounces or so. in the entire night, and one of them puked all over my bed and soiled it! FUCKING BASTARD..........he literally blew chunks all over my bed like the whole bed was covered. AND THEN HE DIDNT CLEAN IT! HE made me clean it up. fucking cocksucker.

I let him sleep in my bed cuz he was drunk and the guy goes and vomits all over my bed not too mention he rolls around in it while he's sleeping and smushes it into the matress it was a NEW matress at the time, california king sized, fucking cocksucker ruined one side of it and it smells rank. And i couldn't believe the guy wouldn't clean it. His own fucking vomit.

This same friend used to sleep over and he would "sleep walk" into my bathroom and piss on things "in his sleep" and then my mom would find his piss everywhere and we just wouldn't speak of it lmao cuz we were so ashamed and grossed out.

He actually got up in his sleep, pulled out his dick, and pissed in one of my moms decorative birdhouses. lmaooo. He filled the thing up with his rank piss.

Some people are fucking weirdos.

[candy]

Phenobarbital itself is not recommended for DT's. It can be used for sedation, but unless you know the correct dosage and how often to give it, it can lead to toxicity.

Helping a freind is great and no one wants to feel like shit if their buddy faces some family or professional problems if going into rehab. But, the best advice and it has been given here is get him to a facility that can take care of him, if you haven't done so already.

I am just always weary of anyone administering meds to someone they are not prescribed for and phenobarbital is one of those meds.

Hope the situation is under control and your friend is doing better!

[OxyContinuously]

Benzodiazepines are the preferred meds for alcohol withdrawal, particularly Valium and Ativan.

[bronyraur]

It's great you wanna help yer buddy out, Opiyum; but think of the fucking guilt trip you'd have if something went wrong with the phenobarbital--what if it wasn't the DT's that killed him? That's too much of a burden IMO. Don't do it man.

Even though he doesn't want to go the hospital route he NEEDS TO.

You know how many hospitals are in our city--surely he can find one that'll keep things hush-hush-or at least be discreet.

[Dolophine]

Yah from what i've read the hospital is the way to go. I'm sure some are discreet it's not something they want to advertise to people u know. it's a very delicate issue. maybe if you phone some places you can find out what they will do and how discreet they are?