Frontiers in Pharmacology (May 2023)

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

  • Sella Takei,
  • Hiroshi Kinoshita,
  • Mostofa Jamal,
  • Mitsuru Kumihashi,
  • Tadayoshi Yamashita,
  • Etsuko Tanaka,
  • Sachiko Kawahara,
  • Hiroko Abe,
  • Kunihiko Tsutsui,
  • Shoji Kimura

DOI
https://doi.org/10.3389/fphar.2023.1196565
Journal volume & issue
Vol. 14

Abstract

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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.

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