Deaths caused by barbiturate overdoses have increased in the past decade,especially as a result of suicide attempts.Pentobarbitone is a central nervous system depressant used for sedation and euthanasia in veterinary ...Deaths caused by barbiturate overdoses have increased in the past decade,especially as a result of suicide attempts.Pentobarbitone is a central nervous system depressant used for sedation and euthanasia in veterinary medicine.However,pentobarbitone analysis is not commonly available in the hospital setting;hence,its occurrence in overdoses is under-reported.Herein we describe a patient who ingested pentobarbitone obtained from the Internet with the purpose of ending his life.He became comatose and required ventilation for 6 days.While critically ill,the drug and a barbiturate test kit were found in his room at his residence.Toxicological analysis of the patient’s blood determined the presence of pentobarbitone at levels of 91,56,and 19 mg/L at 11,59,and 107 h after ingestion,respectively.With supportive care,the patient made a full recovery.He stated that he believed the liquid was to be pentobarbitone,and that he had received advice on its use from an online forum that he had found on a dark web marketplace.In this report,we highlight the process by which we facilitated pentobarbitone analysis with a rapid turnaround time,which helped to inform clinical management and raise awareness among clinicians.The access was made through the Prescription,Recreational and Illicit Substance Evaluation(PRISE)programme,which is a collaborative network among the New South Wales(NSW)Ministry of Health,NSW Poisons Information Centre(PIC),and NSW Health Pathology Forensic&Analytical Science Service(FASS).展开更多
文摘Deaths caused by barbiturate overdoses have increased in the past decade,especially as a result of suicide attempts.Pentobarbitone is a central nervous system depressant used for sedation and euthanasia in veterinary medicine.However,pentobarbitone analysis is not commonly available in the hospital setting;hence,its occurrence in overdoses is under-reported.Herein we describe a patient who ingested pentobarbitone obtained from the Internet with the purpose of ending his life.He became comatose and required ventilation for 6 days.While critically ill,the drug and a barbiturate test kit were found in his room at his residence.Toxicological analysis of the patient’s blood determined the presence of pentobarbitone at levels of 91,56,and 19 mg/L at 11,59,and 107 h after ingestion,respectively.With supportive care,the patient made a full recovery.He stated that he believed the liquid was to be pentobarbitone,and that he had received advice on its use from an online forum that he had found on a dark web marketplace.In this report,we highlight the process by which we facilitated pentobarbitone analysis with a rapid turnaround time,which helped to inform clinical management and raise awareness among clinicians.The access was made through the Prescription,Recreational and Illicit Substance Evaluation(PRISE)programme,which is a collaborative network among the New South Wales(NSW)Ministry of Health,NSW Poisons Information Centre(PIC),and NSW Health Pathology Forensic&Analytical Science Service(FASS).