title: [Three cases of suicidal morbital intoxication--preparation for euthanasia of small animals].
abstract: Three cases of suicidal Morbital intoxication were presented. Morbital is a veterinarian preparation for euthanasia of small animals. This preparation is an injectable solution containing 26.7 mg pentobarbitone and 133.3 mg pentobarbitone sodium per 1 ml. In cases no 1 and no 2 the drug was administered by intravenous self-injection, in case No 3--by oral administration. In all cases the suicide was attempted after alcohol consumption. In the first case only confusion and equilibrium disorder were observed. In the second case coma and flaccidity with hyporeflexia were noted. In the first two cases the blood barbiturates concentration was low (1.46 and 1.42 microg/ml), in addition in case No 2 high benzodiazepine serum concentration was revealed (451.64 ng/m). Because of that, it was concluded that in case No 2 severe patients condition resulted from a mixed intoxication with pentobarbitone, benzodiazepines and ethanol. In the case no 3 deep coma, hypotension and circulatory insufficiency were observed. The blood barbiturates concentration was high (10.14 microg/ml). After 4 days barbiturate serum concentration was dropped and the patient developed symptoms of central nervous system (CNS) injury. The computer tomography showed intracranial hematoma in frontal lobe. Based on these results and history obtained from patients mother it was assumed that the intracranial bleeding is most probably of traumatic etiology. After a neurosurgical consult the patient was transferred to neurology word in order to continue medical treatment. Probably high pentobarbitone concentration in the first three days of hospitalisation was the cause of absence of CNS injury symptoms because diminution of high intracranial pressure associated with hematoma. In all cases the mainstay of therapy was forced diuresis and supportive care (airway protection, mechanical ventilation, vasopressors). No extracorporeal methods of toxin elimination from the blood were used. This paper indicates that self-administration of Morbital-preparation for euthanasia of small animals, may evoke severe intoxication in man.
authors.affiliation: Oddział Ostrych Zatruć Dolnoślaskiego Szpitala Specjalistycznego im. T. Marciniaka we Wrocławiu.
authors.forename: Jan
authors.initials: J
authors.lastname: Magdalan
authors.forename: Andrzej
authors.initials: A
authors.lastname: Antończyk
mesh_terms: D000328:Adult; D062787:Drug Overdose / Q000628:therapy*; D006801:Humans; D006993:Hypnotics and Sedatives / Q000506:poisoning*; D007275:Injections, Intravenous; D008297:Male; D010424:Pentobarbital / Q000506:poisoning*; D013406:Suicide, Attempted; D016896:Treatment Outcome
chemical_list: D006993:Hypnotics and Sedatives; D010424:Pentobarbital