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Influence of cannabidiol on secobarbital effects and plasma kinetics.

To investigate the possible metabolic interaction between cannabidiol (CBD) and secobarbital, 6 male volunteers received 150 mg/70 kg sodium secobarbital orally immediately after smoking a marihuana cigarette prepared to deliver 0, 150, or 500 mug/kg CBD. The study was performed in a double-blind manner with each of the three treatments being assigned to every subject. Clinical effects and plasma secobarbital concentrations were recorded at periodic intervals. CBD did not alter the summary parameters which describe the secobarbital plasma concentration time curve. Secobarbital half-life, peak concentration, time of peak concentration, and area under the curve were unchanged by the coadministration of CBD. Clinical effects of secobarbital were also unaltered by CBD pretreatment. Thus at the doses administered, CBD does not appear to inhibit secobarbital metabolism in man.

Adult

Effectiveness of intermediate-term use of secobarbital.

Secobarbital, 100 mg, was evaluated in two separate sleep laboratory drug evaluation studies, each with 4 insomniac patients. In both studies, the effect of secobarbital in inducing and maintaining sleep was evaluated, as well as the effects of the drug on sleep stages. Statistical analysis demonstrated that the results of the two studies could be combined. With short-term drug administration of secobarbital (up to 3 nights), there was an improvement in both sleep induction and sleep maintenance. Total wake time was decreased 43% below baseline and was consistently decreased in each third of the night. With intermediate-term drug administration (2 wk), total wake time was decreased only 14% (not statistically significant). Following drug withdrawal, the degree of sleep difficulty returned to baseline levels. The results indicate that secobarbital 100 mg is effective for short-term use but loses much of its effectiveness with intermediate use and suggest that the drug is of limited value for insomniac patients who require nightly medication beyond a period of 1 wk. With short-term administration, secobarbital induced a slight decrease in rapid eye movement (REM) and slow-wave sleep and a significant increase in stage 2 sleep. With intermediate administration, sleep stage values were similar to baseline levels. Following withdrawal, there was only a minimal increase in REM sleep above baseline levels, a significant increase in stage 3 sleep, and a significant decrease in stage 2 sleep. The rebound increase in stage 3 sleep is similar to that reported following withdrawal of pentobarbital.

Adult

Pharmacokinetics of secobarbital in rabbit.

The pharmacokinetic study of secobarbital in the rabbit utilizing gas chromatography (GC) indicated a correlation between blood levels and brain tissue levels; and that the distribution of the drug appears to be more complex than a first order process is suggested by the compartmental simulation midel. The liver and kidney which eliminate the drug into bile and urine, respectively, tend to follow first order elimination kinetics more closely than those which act as depots for drug storage such as muscle and fat. The two dose levels of secobarbital indicate the same relationship with blood and tissues, therefore an increase or decrease in the dosage has no effect on the pharmacokinetics of secobarbital. The termination of action of secobarbital is due to the combination of rapid uptake by liver and its disposition there and a slower uptake by muscle. Computer simulation of secobarbital distribution has strongly suggested the elimination of this drug in bile and that the rebound rise in liver amy be due to enterohepatic circulation.

Adipose Tissue

Influence of secobarbital and chlorpromazine on precentral neuron activity during attentive behavior in monkeys.

Precentral motor cortex neurons were studied under non-drug and drug conditions in three trained monkeys during the performance of a go-no go visual "attention" task. The two drugs studied, secobarbital and chlorpromazine, produced differing patterns of effect on components of the motor sequence involved in reaction time. The following components were considered: The SF interval or the period from stimulus onset to change in neuronal firing; the FR interval, which is the period from change in firing to the beginning of the task response; and MT or movement time, which is the time necessary to complete the response. Secobarbital produced an increase of 80% in SF and a relatively small average change in FR although there was considerable variability in the latter. MT was decreased in most secobarbital experiments. Anatomical factors relating to the FR variability were considered, and the MT decrease was discussed in terms of possible excitatory effects of the drug. Chlorpromazine produced small increases in SF, FR and MT, alternating with periods of complete abolition of performance. The results were discussed in terms of theories of attention deficit following administration of secobarbital and chlorpromazine.

Action Potentials

Dose-response studies on tolerance to multiple doses of secobarbital and methaqualone in a polydrug abuse population.

Patients from a polydrug abuse treatment program were titrated with either secobarbital or methaqualone, their primary drug of abuse, to a state of mild intoxication, consisting of lateral and vertical nystagmus, ataxia, slurred speech, and drownsiness. The mean dose required to produce each sign was compared to that determined in a similarly treated control group. Tolerance to secobarbital was more easily demonstrated than tolerance to methaqualone, and nystagmus was the least sensitive indicator of patient tolerance. The individual signs were also cumulated into a graded rating scale of central nervous system depression which would be related to the dose administered. Tolerence was easily demonstrated at the higher stages of toxicity for secobarbital in the overall patient population, but tolerance to methaqualone was only unequivocal in the subjects indicating a relatively high frequency of abuse. Tolerance to methaqualone occurred at the lower stages of toxicity, suggesting that there is a difference between tolerance to secobarbital and tolerance to methaqualone. There was no indication that patients who also abuse alcohol are more tolerant than their patient counterparts. The patients who also had a history of amphetamine abuse, however, were less tolerant than the nonusers of these drugs.

Adolescent

Effects of marihuana combined with secobarbital.

Twelve male volunteers smoked a marihuana cigarette prepared to deliver 0 or 25 mug/kg tetrahydrocannabinol (THC) 50 min after ingesting a capsule containing either placebo or 150 mg/70 kg sodium secobarbital. Drugs were administered in a double-blind manner, and all treatments were assigned to each subject in a randomized complete block design. Objective and subjective tests designed to measure mental and motor performance indicated that marihuana impaired stability, hand-eye coordination, and mental performance. Secobarbital affected motor performance, manual coordination, and mental performance. In combination, marihuana and secobarbital had an additive effect on subjective responses and impairment in certain psychomotor performance tests.

Adult

EEG correlates of impaired attention performance under secobarbital and chlorpromazine in the monkey.

The effects of secobarbital and chlropromazine upon behavior in a continuous, rapidly presented successive (go-no go) discrimination ("attention") task were evaluated in six Macaca mulatta monkeys. Simultaneous monitoring of EEG activity from epidural and subcortical electrodes permitted an evaluation of the nature of altered central nervous system events during erroneous performance (errors of omission) on this task. The computer-assisted analysis of pre-stimulus and post-stimulus EEG frequency activity (baseline crossings) suggests that the best measure of attentive behavior from the pre-stimulus EEG is percentage of beta 2 (25-40 cps) activity. No difference could be observed between drugs or among cerebral placements in this regard. This was determined by comparing measures of EEG frequency, pooled for a given test period, with performance from the same test period. On a trail-by-trail basis. however, the beta 2 measure in the pre-stimulus epoch failed to ditinguish correct responses from errors of omission. Separation between correct responses and errors of omission is possible if comparisons are made between the changes in percentage of beta 2 activity in the pre-stimulus vs. post-stimulus occurs with correct positive trials and the smallest change with correct negative trials. For secobarbital, no difference could be detected between correct and incorrect positive trials. For chlorpromazine, however, there was significantly less change in beta 2 for incorrect positive than for correct positive trials. The results were interpreted in terms of the hypothesis that secobarbital produces errors by depression of the general level of activation whereas chlorpromazine acts by reducing the sensory input which is necessary for correct discrimination performance.

Animals

A clinical comparison of triazolam with placebo and with secobarbital in insomniac patients.

Seventy-six out-patient insomniacs participated in three different two-night, double-blind crossover trials investigating the hypnotic efficacy andsafety of triazolam. Triazolam 0.5 mg was compared to placebo in one trial conducted K Kay Okawa, MD, and triazolam 0.5 mg was compared to secobarbital 100 mg in trials conducted by K Kay Okawa, MD and George S Allen, MD. The results of the later two studies were combined and the data analyzed jointly. Triazolam 0.5 mg was found to be preferred and to be significantly better than both placebo and secobarbital 100 mg in the treatment of insomnia. Analysis of sleep questionnaire data showed triazolam to be superior to either placebo or secobarbital on the following parameters: how much the medication helped the patients sleep; onset of sleep; duration of sleep; and number of nocturnal awakenings. No differences were observed between treatments in any trial with regard to the patient's feeling of alertness the next morning. The side-effects reported for all treatments did not significantly interfere with the patient's ability to function.

Adult

Secobarbital and information processing.

The Sternberg fixed-set memory-search paradigm was used to assess the relative vulnerability of hypothetical stages of information processing to an oral dose of secobarbital (2.9 mg/kg). D-amphetamine (15 mg, oral dose) was intended to serve as an active placebo. However, since the amphetamine produced a slight, non-significant reduction in choice reaction time (RT), the principal analysis of secobarbital effects was conducted between drug and baseline conditions. Secobarbital showed choice RT by 60 msec. and did not increase errors significantly. The results, as interpreted within Sternberg's model, suggest that input processes, e.g., stimulus preprocessing-encoding, are particularly sensitive to the effects of the barbiturate. There was no evidence of a drug effect on cognitive processes associated with serial comparison, binary decision, or translation-response organization (response selection). In contrast, earlier studies have indicated that another CNS depressant, alcohol, interferes with both speed and accuracy of output processes, viz, the response selection stage.

Adult

Overdosage with pentobarbital and secobarbital: assessment of factors related to outcome.

Factors related to clinical outcome following acute overdosage with pentobarbital or secobarbital were assessed in a series of 162 patients hospitalized during the period 1962 to 1975. The mean ingested dose was 2 Gm (range 0.2 to 10.0 Gm), and plasma barbiturate concentrations ranged from 2.0 to 72.0 microgram/ml. Serious intoxication was common. Intubation and assisted ventilation were required in 59 per cent of patients, and 23 per cent developed clinically important hypotension. Four patients died, all relatively young females. Multiple regression and discriminant function analyses, performed on a subset of 88 patients for whom complete data were available, indicated that plasma barbiturate concentration and/or ingested dose were the most important correlates of serious intoxication among identifiable variables available on admission. Coingestion of other central nervous system depressants, such as ethanol, had no obvious effect on outcome. The present study suggests that measurement of plasma barbiturate concentrations is of value in identifying patients at risk of developing serious intoxication after overdosage with pentobarbital or secobarbital.

Adolescent

Smooth-pursuit eye movements, and diazepam, CPZ, and secobarbital.

This study examined the effects on smooth-pursuit eye tracking of single doses of CPZ (0.667 and 1.334 mg/kg), diazepam (0.071, 0.142, and 0.284 mg/kg), and secobarbital (100 mg). Only the barbiturate significantly affected the ability to follow a moving target with smooth-pursuit eye movements. In repeated testing of a single subject, 130 mg of secobarbital disrupted smooth-pursuit movements at least until 24 hrs after ingestion.

Adult

Comparison of progressive-ratio performance maintained by cocaine, methylphenidate and secobarbital.

Cocaine, methylphenidate and secobarbital were compared on a drug maintained progressive-ratio procedure in baboon subjects. Trials, scheduled throughout the day, occurred at a minimum interval of 3 hrs after completion of the preceding trial. A ratio response requirement on the "initiate" lever was required during each trial which terminated in a single intravenous infusion of drug. A drug was introduced on the progressive-ratio procedure with a low ratio requirement in order to obtain a baseline performance of a high stable frequency of trial completion. The ratio requirement was systematically increased every 7 days until the "breaking point" when the rate of completing trials fell below a criterion level. Within-subject comparison revealed that cocaine produced higher breaking points than methylphenidate at the same absolute dose, 0.4 mg/kg. At the range of doses studied, manipulation of doses of methylphenidate (0.1-0.8 mg/kg) and cocaine (0.4-1.6 mg/kg) had little effect on breaking point. In contrast, increasing doses of secobarbital (6.0 and 12.0 mg/kg) produce higher breaking points within the same subjects.

Animals

Effects of D-amphetamine and of secobarbital on optokinetic and rotation-induced nystagmus.

Although vestibular nystagmus is known to be affected by variations in mental states, little information is available about the effects of drugs on vestibular responses when a) subjects are either alert or relaxed, and b) visual stimuli are available or denied. In this study, 30 men were assigned to d-amphetamine sulphage (10 mg), secobarbital sodium (100 mg), or placebo (no drug) groups. With subjects alert in darkness, the drugs had no differential effect on rotation-induced vestibular nystagmus; when subjects were relaxed there was significantly less nystagmus than in the alert condition, particularly for the seco-barbital group. With vision permitted, d-amphetamine had no statistically different effect on nystagmus from the placebo. However, subjects given secobarbital were unable to use visual fixation effectively to suppress vestibular eye movements and their visual-following ability as measured by optokinetic nystagmus was also suppressed. Control over the mental activity of subjects and assessment of oculomotor-related functions both with and without opportunities for visual fixation are both important in evaluating drug effects.

Adult

The negative inotropic effect of secobarbital on the heart of reserpinised newborn and adult guinea pigs.

The negative inotropic effect of different concentrations of secobarbital was studied on isolated hearts of reserpinised newborn and adult guinea pigs. This effect was expressed as the percentage reduction of contraction height, from which the sensitivity of the heart was obtained as the reciprocal of the secobarbital concentration X1/2 needed to yield a 50% reduction (i.e. 1/X1/2). It was found that in adults depletion of catecholamines increased this sensitivity, but not in newborns. Possible interpretations are discussed and it is concluded that the age effects are not due to an effect of reserpine on contractility.

Aging

Comparative drug effects and abuse liability of lorazepam, buspirone, and secobarbital in nondependent subjects.

The pharmacologic effects of lorazepam (2 mg), buspirone (20 mg, 10 mg), secobarbital (100 mg), and placebo were compared in 15 male, experienced, intermittent nontherapeutic drug users. All drugs produced a "drug effect," however, buspirone 20 mg was significantly less liked than were lorazepam, secobarbital, or buspirone 10 mg (p less than .05) but not placebo. Lorazepam was liked better than were other drugs only at 1 hour and only compared with buspirone 20 and placebo. Compared with other drugs, lorazepam drug effects were greater and resulted in more prolonged impairment of a motor tracking task, standing steadiness, and memory. Buspirone 20 mg significantly impaired memory at 1 hour compared with placebo. Subjects were more likely to identify buspirone as unfamiliar. Because buspirone 20 mg was less liked than were other drugs, dose escalation as part of drug abuse is not likely to occur. Lorazepam also was not particularly liked and was not different from placebo on most subjective abuse-relevant measures.

Adult

Column chromatographic analysis of barbiturates in their dosage forms. II. secobarbital, amobarbital, and pentobarbital.

A general method for the analysis of barbiturates, using column parition chromatography, was extended to the assay of secobarbital, amobarbital, and pentobarbital. A solution of the barbiturate constitutes the immobile phase in the chromatographic system. It is eluted with ether-isooctane (1+9) and passed onto a K3PO4 column, which retains the barbiturate while extraneous materials are washed out. The barbiturate is removed from the column with etherisooctane (3+1), extracted from the eluate with NH3, and measured spectrophotometrically.

Amobarbital

Toxic nephropathy after low-dose methoxyflurane anesthesia: drug interaction with secobarbital?

Vasopressin-resistant nonoliguric renal insufficiency developed in a 57-year-old man after 2 1/2 hours of low-dose methoxyflurane anesthesia. Secobarbital, 100 mg daily, had been taken for 1 month before. Of 13 patients in whom the influence of methoxyflurane on renal function was being studied, he was the only one to have taken a drug that induces microsomal enzymes. Blood values of methoxyflurane in this patient were lower than group means on all five occasions during anesthesia. Postoperatively his serum inorganic fluoride value reached 114 mumol/l -- more than two standard deviations greater than the group mean. Peak values for serum urea nitrogen, creatinine and uric acid and postvasopressin urine osmolality, and the lowest creatinine clearance in this patient also differed by more than 2 SD from the group mean, and the peak amount of oxalate excreted in his urine was double the group mean. Pretreatment with the barbiturate appears to have altered methoxyflurane metabolism and led to toxic concentrations of metabolites in the blood.

Drug Interactions

The effect of time of death on extravascular tissue/blood secobarbital concentration ratios in the rat.

Extravascular liver/blood and brain/blood ratios were found to be an average of 6% and 1% higher, respectively, in all experiments than total liver/blood and brain/blood ratios. This difference may be informative in establishing true tissue levels. There was a significant time effect (P less than 0.05) with the extravascular liver/blood ratios but not with the extravscular brain/blood ratios. Extravascular liver/blood ratios were slightly higher in phenobarbital-pretreated animals than in non-pretreated animals. Tissue secobarbital levels in pretreated and non-pretreated animals are not different at 1/4 or 1 h, even though pretreated animals received higher doses than non-pretreated animals. Tissue levels are significantly higher (P less than 0.01) in pretreated animals than in non-pretreated animals at 4 h. It is possible that, at this time period, the barbiturate-metabolizing enzymes have become saturated or exhausted.

Animals