Case report: Fatal poisoning caused by additive effects of two barbiturates

A case of fatal poisoning involving multiple psychotropic drugs is presented. Quantitative toxicological analysis showed femoral blood concentrations of pentobarbital, phenobarbital, duloxetine, acetaminophen and tramadol were 10.39, 22.57, 0.22, 0.61 and 0.22 μg/ml, respectively. We concluded that...

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Published inFrontiers in pharmacology Vol. 14; p. 1196565
Main Authors Takei, Sella, Kinoshita, Hiroshi, Jamal, Mostofa, Kumihashi, Mitsuru, Yamashita, Tadayoshi, Tanaka, Etsuko, Kawahara, Sachiko, Abe, Hiroko, Tsutsui, Kunihiko, Kimura, Shoji
Format Journal Article
LanguageEnglish
Published Switzerland Frontiers Media S.A 24.05.2023
Subjects
additive pharmacological effects
forensic toxicology
massive ingestion
pentobarbital
Pharmacology
phenobarbital
forensic toxicology
phenobarbital
massive ingestion
additive pharmacological effects
pentobarbital
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Summary:A case of fatal poisoning involving multiple psychotropic drugs is presented. Quantitative toxicological analysis showed femoral blood concentrations of pentobarbital, phenobarbital, duloxetine, acetaminophen and tramadol were 10.39, 22.57, 0.22, 0.61 and 0.22 μg/ml, respectively. We concluded that the death was due to the additive effects of two barbiturates. As both pentobarbital and phenobarbital act on gamma-aminobutyric acid (GABA) receptors, central nervous system activity was suppressed, causing respiratory depression. Additive pharmacological effects should be considered in cases of massive ingestion of multiple drugs.
Bibliography:Jerry Campbell, Ramboll, United States
Edited by: Albert P. Li, In Vitro ADMET Laboratories, United States
Reviewed by: Suzana Apostolov, University of Novi Sad, Serbia
ISSN:1663-9812
1663-9812
DOI:10.3389/fphar.2023.1196565