Sodium Thiopental - Barbiturates

Barbiturates

Barbiturates are a class of drugs that act on the GABA_A receptor in the brain and spinal cord. The GABA_A receptor is an inhibitory channel that decreases neuronal activity, and barbiturates enhance the inhibitory action of the GABA_A receptor. Barbiturates, benzodiazepines, and alcohol all bind to the GABA_A receptor. Barbiturates that act on the barbiturate binding site of the GABA_A receptor directly gate the chloride ion channel of the GABA_A receptor, whereas benzodiazepines acting on the benzodiazepine site on the GABA_A receptor increase the opening frequency of the chloride ion channel. This explains why overdoses of barbiturates may be lethal whereas overdoses of benzodiazepines alone are typically not lethal. Another explanation is that barbiturates can activate GABA receptors in the absence of the GABA molecule, whereas benzodiazepines need GABA to be present to have an effect: this may explain the more widespread effects of barbiturates in the central nervous system. Barbiturates have anesthetic, sedative, anxiolytic, anticonvulsant and hypnotic properties. Barbiturates do not have analgesic effects.

Further, barbiturates are relatively non-selective compounds that bind to an entire superfamily of ligand-gated ion channels, of which the GABA_A receptor channel is only one of several representatives. This superfamily of ion channels includes the neuronal nACHR channel, the 5HT3R channel, the GlyR channel and others. Surprisingly, while GABA_A receptor currents are increased by barbiturates (and other general anesthetics), ligand-gated ion channels that are predominantly permeable for cationic ions are blocked by these compounds. For example, neuronal nACHR channels are blocked by clinically relevant anesthetic concentrations of both sodium thiopental and pentobarbital. Such findings implicate (non-GABA-ergic) ligand-gated ion channels, e.g. the neuronal nAChR channel, in mediating some of the (side) effects of barbiturates.