Observation and patient disposition after barbiturate poisoning

Admit patients to an intensive care unit if they have coma due to barbiturate poisoning.

Monitor the degree of CNS and respiratory depression in patients with barbiturate poisoning for at least 6 hours after ingestion. Discharge patients once they are alert and asymptomatic.

Sedative drugs can continue to cause significant cognitive impairment for several days following exposure. Advise patients not to drive or operate machinery for at least 3 days after discharge.

Patients who take barbiturates long-term are susceptible to withdrawal if the serum barbiturate concentration drops rapidly following treatment for poisoning. Withdrawal develops 48 to 72 hours after withholding the drug and can be severe, manifesting as seizures and delirium. Restart the patient’s maintenance therapy once barbiturate toxicity has resolved.