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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Abstract 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.
AbstractList 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.
Author Kawahara, Sachiko
Takei, Sella
Jamal, Mostofa
Tanaka, Etsuko
Tsutsui, Kunihiko
Kinoshita, Hiroshi
Kumihashi, Mitsuru
Yamashita, Tadayoshi
Abe, Hiroko
Kimura, Shoji
AuthorAffiliation 2 Biodesign Inc , Tokyo , Japan
3 Kagawa Prefectural University of Health Sciences , Takamatsu , Kagawa , Japan
1 Departments of Forensic Medicine , Faculty of Medicine , Kagawa University , Takamatsu , Japan
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10.3109/15563657008990108
10.1007/3-540-27579-7_33
10.1186/cc11441
10.4323/rjlm.2017.193
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Copyright Copyright © 2023 Takei, Kinoshita, Jamal, Kumihashi, Yamashita, Tanaka, Kawahara, Abe, Tsutsui and Kimura.
Copyright © 2023 Takei, Kinoshita, Jamal, Kumihashi, Yamashita, Tanaka, Kawahara, Abe, Tsutsui and Kimura. 2023 Takei, Kinoshita, Jamal, Kumihashi, Yamashita, Tanaka, Kawahara, Abe, Tsutsui and Kimura
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Keywords forensic toxicology
phenobarbital
massive ingestion
additive pharmacological effects
pentobarbital
Language English
License Copyright © 2023 Takei, Kinoshita, Jamal, Kumihashi, Yamashita, Tanaka, Kawahara, Abe, Tsutsui and Kimura.
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SubjectTerms additive pharmacological effects
forensic toxicology
massive ingestion
pentobarbital
Pharmacology
phenobarbital
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Title Case report: Fatal poisoning caused by additive effects of two barbiturates
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