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

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

Affiliation
Departments of Forensic Medicine ,Faculty of Medicine ,Kagawa University ,Takamatsu ,Japan
Takei, Sella;
Affiliation
Departments of Forensic Medicine ,Faculty of Medicine ,Kagawa University ,Takamatsu ,Japan
Kinoshita, Hiroshi;
Affiliation
Departments of Forensic Medicine ,Faculty of Medicine ,Kagawa University ,Takamatsu ,Japan
Jamal, Mostofa;
Affiliation
Departments of Forensic Medicine ,Faculty of Medicine ,Kagawa University ,Takamatsu ,Japan
Kumihashi, Mitsuru;
Affiliation
Departments of Forensic Medicine ,Faculty of Medicine ,Kagawa University ,Takamatsu ,Japan
Yamashita, Tadayoshi;
Affiliation
Departments of Forensic Medicine ,Faculty of Medicine ,Kagawa University ,Takamatsu ,Japan
Tanaka, Etsuko;
Affiliation
Departments of Forensic Medicine ,Faculty of Medicine ,Kagawa University ,Takamatsu ,Japan
Kawahara, Sachiko;
Affiliation
Biodesign Inc ,Tokyo ,Japan
Abe, Hiroko;
Affiliation
Kagawa Prefectural University of Health Sciences ,Takamatsu ,Kagawa ,Japan
Tsutsui, Kunihiko;
Affiliation
Departments of Forensic Medicine ,Faculty of Medicine ,Kagawa University ,Takamatsu ,Japan
Kimura, Shoji

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.

Category

Published in:
Frontiers in Pharmacology  
Vol. 14 (24.05.2023)
Volume:
14
Date Issued:
24.05.2023
DOI:
10.3389/fphar.2023.1196565
Language:
English
Type of Resource:
Text
Keywords:
pentobarbital; phenobarbital; additive pharmacological effects; massive ingestion; forensic toxicology
Subject of DNB:
610 Medical sciences Medicine

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License Holder: Copyright © 2023 Takei, Kinoshita, Jamal, Kumihashi, Yamashita, Tanaka, Kawahara, Abe, Tsutsui and Kimura.

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