FRCA Notes


Barbiturate Pharmacology


  • Barbiturates are derived from barbituric acid, a condensation of malonic acid and urea
barbituric acid
  • Barbituric acid has a pyrimidine ring nucleus
  • It is not a CNS depressant

Oxybarbiturates

  • As an oxygen molecule is bonded at the C2 carbon, barbituric acid is an oxybarbiturate
  • Oxybarbiturates are poorly lipid soluble and poorly protein bound
  • They are excreted almost entirely unchanged in the urine
  • When a sulphur group is exchanged in for an oxygen at C2, oxybarbiturates become thiobarbiturates

Thiobarbiturates

  • Thiobarbiturates are:
    • Highly lipid soluble and protein bound
    • Completely metabolised in the liver

  • This provides them with a fast onset of action, yet also a short duration of action and short recovery period


keto-enol transformation
  • Thiobarbiturates are poorly water soluble at neutral pH, existing in their keto form
  • In order to become water soluble, it is necessary for them to exist in their enol form
    • This process is favoured by alkaline environments
    • This is an example of dynamic structural isomerism - tautomerisation

  • Barbiturates facilitate inhibitory synaptic transmission by:
    • Agonising the GABAA receptor by binding to the GA site on the β subunit
    • Antagonising AMPA and kainite (non-NMDA) glutamate receptors, inhibiting excitatory post-synaptic transmission
    • Antagonising neuronal nAChR and K+ channels
  • They also provide a neuroprotective effect by:
    • Antagonising voltage gated sodium and calcium channels
    • Scavenging free radicals