title: Massive strychnine intoxication: serial blood levels in a fatal case.
abstract: A fatal case of strychnine intoxication is reported. The patient expired despite early aggressive management and prevention of metabolic complications. Serial blood levels are reported. In contrast to a previous report describing first order elimination kinetics, our data suggest that strychnine follows Michaelis-Menton elimination kinetics. The case illustrates the rapid, dramatic course of severe strychnine ingestions. A review of the toxicokinetics, mechanism of action and treatment of strychnine intoxication follows.
authors.affiliation: Oregon Health Sciences University, Portland.
authors.forename: J M
authors.initials: JM
authors.lastname: Heiser
authors.forename: M R
authors.initials: MR
authors.lastname: Daya
authors.forename: A R
authors.initials: AR
authors.lastname: Magnussen
authors.forename: R L
authors.initials: RL
authors.lastname: Norton
authors.forename: D A
authors.initials: DA
authors.lastname: Spyker
authors.forename: D W
authors.initials: DW
authors.lastname: Allen
authors.forename: W
authors.initials: W
authors.lastname: Krasselt
mesh_terms: D001344:Autopsy; D001933:Brain Stem / Q000187:drug effects / Q000473:pathology; D002540:Cerebral Cortex / Q000187:drug effects / Q000473:pathology; D003975:Diazepam / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D011041:Poisoning / Q000401:mortality / Q000628:therapy; D013331:Strychnine / Q000097:blood / Q000493:pharmacokinetics / Q000506:poisoning*
chemical_list: D013331:Strychnine; D003975:Diazepam